Southeast Family Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2013-01926 Issued in NC

Legal business name

SOUTHEAST FAMILY CARE PLLC

Practice address

10035 Park Cedar Dr Ste 100
Charlotte, NC 28210-8910

Phone

(704) 544-2524

Fax

(704) 544-2647

NPI assigned

Aug 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Hirenkumar D Italia, MD

Title

President/Physician

Phone

(704) 512-9921

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1831615160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 DANIEL PLACE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28213",
            "telephone_number": "704-544-2524",
            "fax_number": "704-544-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10035 PARK CEDAR DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108910",
            "telephone_number": "704-544-2524",
            "fax_number": "704-544-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST FAMILY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "ITALIA",
        "authorized_official_first_name": "HIRENKUMAR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "704-512-9921",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-01926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southcross Family Medicine PLLC
• Southcross Family Medicine PLLC
• Southeast Addiction Institute and Learning Center, Inc (Sail)
• Southeast Anesthesiology Consultants, PLLC
• Southeast Bariatrics
• Southeast Pain Management Services, PLLC
• Southeast Pathology Consultants, Inc.
• Southeast Psychological Services PLLC
• Southeast Psychological Services, PLLC
• Southeast Radiation Oncology Group, P.a.

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.