Individual provider Active NPI

Perry J Depietro, D.O.

  • Occupational Medicine Physician
  • Charlotte, NC
National Provider Identifier
1972621910
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
200100134 Issued in NC
Practice address
1614 South Blvd
Charlotte, NC 28203-4726
Phone
(704) 338-1268
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 200100134 NC Primary

Addresses

Primary practice location

1614 South Blvd
Charlotte, NC 28203-4726

Mailing address

720 Cool Springs Blvd
Suite 300
Franklin, TN 37067-2626
Phone (615) 778-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000641 NC Practitioner - Family Practice 0941336739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care of North Carolina PCGroup PAC ID 8426196098, 19 clinicians

Practice addresses (Care Compare)

1614 S Blvd
Charlotte, NC 28203-4726
Phone (704) 338-1268

4221 Tuckaseegee Rd
Charlotte, NC 28208-2801
Phone (704) 395-0060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37713SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of North Carolina PC CurrentSince Feb 1, 2010 Accepting new patients
American Current Care of North Carolina, P.C. CurrentSince Feb 1, 2010 Accepting new patients

Locations

1614 South Blvd
Charlotte, NC 28203
Phone (704) 338-1268

4221 Tuckaseegee Rd
Charlotte, NC 28208
Phone (704) 392-4057

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1972621910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COOL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672626",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034726",
            "telephone_number": "704-338-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPIETRO",
        "first_name": "PERRY",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NC",
            "license": "200100134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.