Carolinas Physicians Network Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CAROLINAS PHYSICIANS NETWORK INC

Practice address

200 Hospital Ave
Suite 200
Jefferson, NC 28640-9244

Phone

(336) 846-8334

Fax

(336) 846-8339

NPI assigned

Mar 25, 2010

Organization subpart

Yes

Parent organization

CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

Name

Daniel L Wiens

Title

Senior Vice President Operations

Phone

(704) 355-0648

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Lepors Harris, NP

  • Nurse Practitioner
  • Huntersville, NC
  • NPI 1922138551
  NPD
• Ann J. Homa, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1881242253
  NPD

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Cotswold Urgent Care

Locations

• The Sanger Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 18, 2013.

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1871817403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60122",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600122",
            "telephone_number": "336-846-8334",
            "fax_number": "336-846-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "address_2": "SUITE 200",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-8334",
            "fax_number": "336-846-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2010-03-25",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT OPERATIONS",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QPB744",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903111",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sanger Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Michael Byrd, LCSW, LCAS
• Ethelin Camille Cammock, MD
• Christopher Darrell Campbell, M. D.
• Daniel Caputo, P.A.
• Fabiola Coromoto Cardozo Gallagher, MD
• Stephanie Ann Chapman, D.M.D.
• Charles W Jones MD PA
• Charles W Jones MD PA Endoscopy Suite
• Charles W Jones MD PA Endoscopy Unit
• Chauncey B Santos MD PC

• All providers in Jefferson, NC
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.