NPIMap

Organization Active NPI

Carolina Family Healthcare, PA

  • Clinic Pharmacy
  • Charlotte, NC
National Provider Identifier
1902251978
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
03735 Issued in NC
Legal business name
CAROLINA FAMILY HEALTHCARE, PA
Practice address
11220 Elm LN
Suite 102
Charlotte, NC 28277-0715
Phone
(704) 847-4000
Fax
(704) 847-4001
NPI assigned
Apr 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Authorized official

Name
Dr. Dino Kanelos, MDNPI 1306959705
Title
President
Phone
(704) 847-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 03735 NC Primary

Addresses

Primary practice location

11220 Elm LN
Suite 102
Charlotte, NC 28277-0715

Mailing address

11220 Elm LN
Suite 102
Charlotte, NC 28277-0715
Phone (704) 847-4000

National Provider Directory

National Provider Directory
Tax ID family
Carolina Family Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1902251978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 ELM LN",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770715",
            "telephone_number": "704-847-4000",
            "fax_number": "704-847-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 ELM LN",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770715",
            "telephone_number": "704-847-4000",
            "fax_number": "704-847-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FAMILY HEALTHCARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "KANELOS",
        "authorized_official_first_name": "DINO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-847-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NC",
            "license": "03735",
            "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 Apr 27, 2016; 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.