Active NPI
Randy Patterson
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1841747581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12472
- Practice address
- 6220 Thermal Rd
Charlotte, NC 28211-5630 - Phone
- (704) 366-8712
- NPI assigned
- Sep 9, 2016
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A12472 | NC | Primary |
Addresses
Primary practice location
6220 Thermal Rd
Charlotte, NC 28211-5630
Mailing address
8217 Pence Rd Apt C
Charlotte, NC 28215-4352
Other practice location 1
769 N Wendover Rd
Charlotte, NC 28211-1118
Phone (828) 376-7180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12472 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexander Youth Network | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1518060318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1841747581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8217 PENCE RD APT C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282154352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6220 THERMAL RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282115630",
"telephone_number": "704-366-8712"
}
],
"practiceLocations": [
{
"address_1": "769 N Wendover Rd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282111118",
"country_code": "US",
"telephone_number": "828-376-7180",
"fax_number": "828-531-9266",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATTERSON",
"first_name": "RANDY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.