Individual provider Active NPI

Maxine Semaneh Eikani, MD

  • Pediatric Pulmonology Physician
  • Charlotte, NC
National Provider Identifier
1841477478
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
2017-00947 Issued in NC
Practice address
6331 Carmel Rd Ste 102
Charlotte, NC 28226-8286
Phone
(704) 316-5280
Fax
(704) 316-5852
NPI assigned
Jan 25, 2008
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 57231-20 WI
Pediatric Pulmonology Physician 2080P0214X 2017-00947 NC Primary

Addresses

Primary practice location

6331 Carmel Rd Ste 102
Charlotte, NC 28226-8286

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1056

Other practice location 1

1918 Randolph Rd Ste 700
Charlotte, NC 28207-1167
Phone (704) 316-5280

Other practice location 2

9000 W Wisconsin Ave
Suite B620
Milwaukee, WI 53226-4874
Phone (414) 266-6733

Other practice location 3

201 Queens Rd
Charlotte, NC 28204-3217
Phone (704) 316-5280

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address meikani440102@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027001991 NC Practitioner - Pediatric Medicine 2668660077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57231-20WIMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 19, 2017 Accepting new patients
Novant Health Medical Group, LLC Pediatric Pulmonology CurrentSince Jul 19, 2017 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 700
Charlotte, NC 28207
Phone (704) 342-3544

201 Queens Rd
Charlotte, NC 28204
Phone (704) 316-5285

6331 Carmel Rd
Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: meikani440102@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1841477478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 CARMEL RD STE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268286",
            "telephone_number": "704-316-5280",
            "fax_number": "704-316-5852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1918 Randolph Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071167",
            "country_code": "US",
            "telephone_number": "704-316-5280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "Suite B620",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532264874",
            "country_code": "US",
            "telephone_number": "414-266-6733",
            "fax_number": "414-266-6742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Queens Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043217",
            "country_code": "US",
            "telephone_number": "704-316-5280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIKANI",
        "first_name": "MAXINE",
        "middle_name": "SEMANEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "WI",
            "license": "57231-20",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NC",
            "license": "2017-00947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "meikani440102@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "9000 W Wisconsin Ave",
            "address_2": "Suite B620",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532264874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.