NPIMap

Organization Active NPI

Emergency Medicine Physicians of Mecklenburg County, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1912232182
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY MEDICINE PHYSICIANS OF MECKLENBURG COUNTY, PLLC
Practice address
10628 Park Rd
Charlotte, NC 28210-8407
Phone
(330) 493-4443
NPI assigned
Oct 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Steven Eisenberg
Title
Secretary
Phone
(330) 493-4443

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

10628 Park Rd
Charlotte, NC 28210-8407

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100119000374 NC Part B Supplier - Clinic/Group Practice 3870635584 Receives reassigned benefits from 313 practitioners
Practice locations: Elizabeth City, NC

National Provider Directory

National Provider Directory

Locations

3050 Halstead Blvd Ext
Rm 2147
Elizabeth City, NC 27909
Phone (330) 492-4443

2711 Lane St
Kannapolis, NC 28083
Phone (704) 403-1275

Practitioners & affiliated clinicians

Practitioners 399

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

View all 399

NPI Registry JSON

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1912232182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "330-493-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE PHYSICIANS OF MECKLENBURG COUNTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "EISENBERG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "330-493-4443"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 9, 2023; 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.