Organization Active NPI

Carolinas Physicians Network Inc

Doing business as The Sanger Clinic

  • Pediatric Cardiology Physician
  • Huntersville, NC
National Provider Identifier
1902121320
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
The Sanger Clinic
Practice address
16623 Birkdale CMNS Pkwy Ste 110
Huntersville, NC 28078-5622
Phone
(704) 373-0212
Fax
(704) 372-1670
NPI assigned
Mar 29, 2010
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Daniel L Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X Primary

Addresses

Primary practice location

16623 Birkdale CMNS Pkwy Ste 110
Huntersville, NC 28078-5622

Mailing address

PO Box 60122
Charlotte, NC 28260-0122
Phone (704) 373-0212

Other identifiers 1

IdentifierTypeStateIssuer
5908740MedicaidNC

Other names 1

  • The Sanger Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000455 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 1,949 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Diabetes Endocrine Osteopo135 organizations share this tax ID, including this one
Part of
Diabetes Endocrine Osteopo

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1902121320",
    "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": "704-373-0212",
            "fax_number": "704-372-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16623 BIRKDALE CMNS PKWY STE 110",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785622",
            "telephone_number": "704-373-0212",
            "fax_number": "704-372-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2010-03-29",
        "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",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908740",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sanger Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • 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.