NPIMap

Individual provider Active NPI

David Rubben Etienne, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1942704317
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME145925 Issued in FL
Practice address
12016 Lemmond Farm Dr Ste 200
Charlotte, NC 28227-8353
Phone
(704) 863-0600
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME145925 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2024-00108 NC

Addresses

Primary practice location

12016 Lemmond Farm Dr Ste 200
Charlotte, NC 28227-8353

Mailing address

12016 Lemmond Farm Dr Ste 200
Charlotte, NC 28227-8353
Phone (704) 863-0600

Other practice location 1

5270 Babcock St NE Ste 1
Palm Bay, FL 32905-4616
Phone (321) 241-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL, NC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201231000102 NJ Practitioner - Family Practice 3779822283 Reassigns benefits to 1 organization
I20211230002080 FL Practitioner - Family Practice 3779822283 Reassigns benefits to 1 organization
I20250518000069 NC Practitioner - Family Practice 3779822283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

12016 Lemmond Farm Dr
Suite 200
Charlotte, NC 28227-8353
Phone (704) 863-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira SJ Urgent Care PC CurrentSince Mar 25, 2024 Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Dec 21, 2021 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jun 9, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jun 9, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Medfast Urgent Care Centers LLC CurrentSince Dec 21, 2021 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients
South Jersey Urgicare LLC PastSince Jul 1, 2014 Accepting new patients

Locations

820 Palm Bay Rd NE
Ste 110
Palm Bay, FL 32905
Phone (321) 409-8140

490 Centre Lake Dr NE
Ste 200
Palm Bay, FL 32907
Phone (321) 821-4950

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

12016 Lemmond Farm Dr
#200
Charlotte, NC 28227
Phone (704) 863-0600

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

3722 E Landis Ave
Ste Ij
Vineland, NJ 08361
Phone (856) 213-5900

3722 E Landis Ave
Unit 1
Vineland, NJ 08361
Phone (856) 213-5900

3722 E Landis Ave
Ste I
Vineland, NJ 08361
Phone (856) 213-5900

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: detienne3008554@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1942704317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12016 LEMMOND FARM DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282278353",
            "telephone_number": "704-863-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12016 LEMMOND FARM DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282278353",
            "telephone_number": "704-863-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5270 Babcock St NE Ste 1",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329054616",
            "country_code": "US",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "DAVID",
        "middle_name": "RUBBEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME145925",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-00108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.