NPIMap

Organization Active NPI

Union Physicians Network Inc

Doing business as Indian Trail Pediatrics

  • Pediatrics Physician
  • Indian Trail, NC
National Provider Identifier
1952477671
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNION PHYSICIANS NETWORK INC
Doing business as
Indian Trail Pediatrics
Practice address
6030 W Highway 74
Suite F
Indian Trail, NC 28079-3468
Phone
(704) 246-2900
Fax
(704) 246-2899
NPI assigned
Nov 27, 2006
Last updated
Aug 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
UNION PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Authorized official

Name
Mr. Daniel L Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

6030 W Highway 74
Suite F
Indian Trail, NC 28079-3468

Mailing address

PO Box 601892
Charlotte, NC 28260-1892
Phone (704) 246-2900

Other identifiers 1

IdentifierTypeStateIssuer
5905684MedicaidNC

Other names 1

  • Indian Trail Pediatrics 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

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1952477671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601892",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601892",
            "telephone_number": "704-246-2900",
            "fax_number": "704-246-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 W HIGHWAY 74",
            "address_2": "SUITE F",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793468",
            "telephone_number": "704-246-2900",
            "fax_number": "704-246-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNION PHYSICIANS NETWORK INC",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-08-19",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905684",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Trail Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.