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CREATE U MEDICAL WEIGHT LOSS PLLC NPI 1487313102


NPI Information

NPI: 1487313102
Provider Name: CREATE U MEDICAL WEIGHT LOSS, PLLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 34D2262789

Address:
10210 HICKORYWOOD HILL AVE STE 200
HUNTERSVILLE, NC
ZIP 28078
Phone: (704) 781-8170
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CREATE U MEDICAL WEIGHT LOSS, PLLC is a multi-specialty clinic center in Huntersville, NC. CREATE U MEDICAL WEIGHT LOSS, PLLC NPI is 1487313102. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10210 HICKORYWOOD HILL AVE STE 200
HUNTERSVILLE, NC
ZIP 28078-417
Phone: (704) 781-8170

The provider's authorized official is Tiffany Jackson .
The authorized official title is Ceo and has the following contact phone number (704) 781-8170.

The CLIA number assigned to this NPI record is 34D2262789 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/9/2021 and was last updated on 7/13/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133NN1002XNutritionistNutrition, EducationNo
2163WG0000XRegistered NurseGeneral PracticeNo
3163WI0500XRegistered NurseInfusion TherapyNo
4163WP2201XRegistered NurseAmbulatory CareNo
5163WW0000XRegistered NurseWound CareNo
6164W00000XLicensed Practical NurseNo
72083B0002XPreventive MedicineObesity MedicineNo
8225100000XPhysical TherapistNo
9225200000XPhysical Therapy AssistantNo
10225700000XMassage TherapistNo
11251F00000XHome InfusionNo
12261QI0500XClinic/CenterInfusion TherapyNo
13363AM0700XPhysician AssistantMedicalNo
14363L00000XNurse PractitionerNo
15261QM1300XClinic/CenterMulti-SpecialtyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11053556399OTHERNPI
21487948154OTHERNPI

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: 5/5/2024
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