NPIMap

Organization Active NPI

Quality Care Medical Clinic

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1851761407
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
190528 Issued in NC
Legal business name
QUALITY CARE MEDICAL CLINIC
Practice address
5124 Monroe Rd
Charlotte, NC 28205-7826
Phone
(980) 777-3651
Fax
(704) 983-9242
NPI assigned
Sep 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Pacharo Sally Ndupu, NP-C
Title
Owner/Operator
Phone
(980) 777-3651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 190528 NC Primary

Addresses

Primary practice location

5124 Monroe Rd
Charlotte, NC 28205-7826

Mailing address

5124 Monroe Rd
Charlotte, NC 28205-7826
Phone (980) 777-3651

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1851761407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057826",
            "telephone_number": "980-777-3651",
            "fax_number": "704-983-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5124 MONROE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057826",
            "telephone_number": "980-777-3651",
            "fax_number": "704-983-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY CARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "NDUPU",
        "authorized_official_first_name": "PACHARO",
        "authorized_official_middle_name": "SALLY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "980-777-3651",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "190528",
            "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 Sep 25, 2015; 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.