NC Medtech PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

77796 Issued in NC

Legal business name

NC MEDTECH PLLC

Doing business as

Metrolina Plastic Surgery

Practice address

10620 Park Rd
Suite 102
Charlotte, NC 28210-8472

Phone

(305) 866-9951

Fax

(877) 284-8933

NPI assigned

Aug 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Broc Lane Pratt, M.D.

Title

President

Phone

(704) 541-7654

Specialties & licenses 2

Addresses

Other names 1

• Metrolina Plastic Surgery Doing business as

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1922256254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 PARK RD",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "704-541-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD",
            "address_2": "SUITE 102",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "305-866-9951",
            "fax_number": "877-284-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC MEDTECH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "BROC",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-541-7654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "77796",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "77796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metrolina Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.