NPIMap

Organization Active NPI

Union Physicians Network Inc

  • Family Medicine Physician
  • Waxhaw, NC
National Provider Identifier
1922017391
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNION PHYSICIANS NETWORK INC
Practice address
2700 Providence Road South
Suite 300
Waxhaw, NC 28173
Phone
(704) 243-2254
Fax
(704) 243-2339
NPI assigned
Aug 5, 2006
Organization subpart
Yes
Parent organization
UNION PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2700 Providence Road South
Suite 300
Waxhaw, NC 28173

Mailing address

PO Box 601215
Charlotte, NC 28260-1215
Phone (704) 243-2254

Other identifiers 2

IdentifierTypeStateIssuer
89012UNMedicaidNC
012UNOtherNCBLUE CROSS - BLUE SHIELD

Other names 1

  • Medical Group of Waxhaw Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Union Physicians Network Inc24 organizations share this tax ID, including this one
Part of
Union Physicians Network Inc

Other organizations with this tax ID 23

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

View all 23

Practitioners 4

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1922017391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601215",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601215",
            "telephone_number": "704-243-2254",
            "fax_number": "704-243-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 PROVIDENCE ROAD SOUTH",
            "address_2": "SUITE 300",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "28173",
            "telephone_number": "704-243-2254",
            "fax_number": "704-243-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNION PHYSICIANS NETWORK INC",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-12-02",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012UN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - BLUE SHIELD",
            "identifier": "012UN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Group of Waxhaw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.