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MECKLENBURG MEDICAL GROUP NPI 1366768152


NPI Information

NPI: 1366768152
Provider Name: MECKLENBURG MEDICAL GROUP
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
1025 MOREHEAD MEDICAL DRIVE
SUITE 200
CHARLOTTE, NC
ZIP 28204
Phone: (704) 302-8000
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MECKLENBURG MEDICAL GROUP is a durable medical equipment medical supplies in Charlotte, NC. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. MECKLENBURG MEDICAL GROUP NPI is 1366768152. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1025 MOREHEAD MEDICAL DRIVE
SUITE 200
CHARLOTTE, NC
ZIP 28204-965
Phone: (704) 302-8000
Fax: (704) 302-8001

The provider's authorized official is Daniel L Wiens .
The authorized official title is Senior Vice President and has the following contact phone number (704) 355-0648.

The enumeration date for this NPI number is 4/19/2010 and was last updated on 6/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyNo
2207RB0002XInternal MedicineObesity MedicineNo
3207RC0000XInternal MedicineCardiovascular DiseaseNo
4207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
5207RG0100XInternal MedicineGastroenterologyNo
6207RG0300XInternal MedicineGeriatric MedicineNo
7207RH0003XInternal MedicineHematology & OncologyNo
8207RI0200XInternal MedicineInfectious DiseaseNo
9207RP1001XInternal MedicinePulmonary DiseaseNo
10207RR0500XInternal MedicineRheumatologyNo
11207RS0012XInternal MedicineSleep MedicineNo
12207RX0202XInternal MedicineMedical OncologyNo
13332B00000XDurable Medical Equipment & Medical SuppliesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17705294OTHERNORTH CAROLINAMEDICAID DME
25165580006OTHERNORTH CAROLINAMEDICARE DME
32308340MEDICARE PINNORTH CAROLINA
4E08621MEDICAIDSOUTH CAROLINA
55903117MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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