Active NPI
David McClellan, AGACNP
- Acute Care Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1992465876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 5015511
- Practice address
- 1000 Blythe Blvd
Charlotte, NC 28203-5812 - Phone
- (704) 355-2000
- NPI assigned
- Dec 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 5015511 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
Charlotte, NC 28203-5812
Mailing address
6135 Park South Dr Ste 510
Charlotte, NC 28210-0100
Phone (704) 749-3116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5015511 | NC | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1992465876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6135 PARK SOUTH DR STE 510",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282100100",
"telephone_number": "704-749-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "DAVID",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-20",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NC",
"license": "5015511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.