NPIMap

Organization Active NPI

Raleigh Durham Medical Group, PA

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1902264435
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Practice address
10620 Park Rd
Suite 128
Charlotte, NC 28210-8472
Phone
(704) 542-6111
Fax
(704) 542-1239
NPI assigned
Jan 28, 2016
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
David Moye
Title
Executive Director
Phone
(919) 233-5956

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

10620 Park Rd
Suite 128
Charlotte, NC 28210-8472

Mailing address

5420 Wade Park Blvd
Ste 106
Raleigh, NC 27607-4188
Phone (919) 233-5952

Other names 1

  • Larry F. Berman, MD, PC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Durham Medical66 organizations share this tax ID, including this one
Part of
Raleigh Durham Medical

Organizations with this tax ID in the same state 17

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

View all 17

Locations

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1902264435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-233-5952",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD",
            "address_2": "SUITE 128",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "704-542-6111",
            "fax_number": "704-542-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP, PA",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-233-5956"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larry F. Berman, MD, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 28, 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.