Internal Medicine & Wellness Center PA

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

Legal business name

INTERNAL MEDICINE & WELLNESS CENTER PA

Practice address

10320 Mallard Creek Rd
Charlotte, NC 28262-9756

Phone

(704) 503-1332

Fax

(704) 503-7951

NPI assigned

Apr 19, 2006

Last updated

Dec 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John William Woodward II, MDNPI 1508072620

Title

Owner/President

Phone

(704) 503-6321

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John William Woodward II, MD

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1508072620
  Medicare reassignment Care Compare group Authorized official
• David Scott Moss, M.D.

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1255413597
  Medicare reassignment Care Compare group
• Daniel James Lackey, NP

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1548755432
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1871558262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 MALLARD CREEK RD STE 271",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625204",
            "telephone_number": "045-036-3217",
            "fax_number": "704-503-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 MALLARD CREEK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629756",
            "telephone_number": "704-503-1332",
            "fax_number": "704-503-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE & WELLNESS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "WOODWARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "704-503-6321",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "6811",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508072620",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interim Healthcare of the Triad
• Interim Healthcare of the Triad, Inc.
• Interim Healthcare of the Triad, Inc.
• Interim Healthcare of the Triad, Inc.
• Interim Healthcare of the Triad, Inc.
• Internal Medicine Associates of Charlotte, P.a.
• Internal Medicine Specialist, PA
• Intouch Counseling Solutions PLLC
• Intrinsic Counseling Services PLLC (Ics,PLLC)
• Intrusted Care Solutions Inc

• Ph.D. Medical Genetics in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ph.D. Medical Genetics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.