SELECT HEALTH PAIN AND REGENERATIVE MEDICINE PC (NPI# 1124636667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124636667 |
| Entity Type | Organization |
| Organization Name | SELECT HEALTH PAIN AND REGENERATIVE MEDICINE PC |
| Practice Address |
15720 Brixham Hill Ave Ste 130 Charlotte NC 28277-4784 |
| Practice Telephone | 7045415555 |
| Mailing Telephone | 7045415555 |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | ERIC SHAPIRO (PRESIDENT) |
| Authorized Official Telephone | 7047632151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
15720 BRIXHAM HILL AVE STE 130 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-4784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484031 | Stacey C Bohm | Nurse Practitioner | 15720 Brixham Hill Ave Ste 130, Charlotte, NC 28277-4784 | 2020-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184055 | Healthworks Med Group of North Carolina P C | General Practice | 2320 Cascade Pointe Blvd, Charlotte, NC 28208-7203 | 2020-08-11 |
| 1053953125 | Emergent Life Integrative Medicine Center, Inc | General Practice | 5104 Reagan Drive, Suite 4, Charlotte, NC 28206-1392 | 2019-10-10 |
| 1780189902 | Izadora Izidoro Diehl | General Practice | 5128 Silabert Ave, Charlotte, NC 28205-7863 | 2018-03-28 |
| 1851799696 | Hak Jin Kim | General Practice | 2095 Brunswick Place, Charlotte, MI 48813-9751 | 2014-12-10 |
| 1992055941 | Healthworks Med Group of North Carolina P C | General Practice | 2605 Water Ridge Pkwy, Suite 100, Charlotte, NC 28217-4565 | 2012-09-18 |
| 1811296494 | Rene Chike Anikwue | General Practice | 5109 Monroe Rd Ste E, Charlotte, NC 28205-7878 | 2011-03-21 |
| 1235433723 | David Joseph Pasek | General Practice | 9216 Forest Manor Ct, Charlotte, NC 28215-9705 | 2010-12-27 |
| 1053625574 | Chs North Carolina Medical, P.C. | General Practice | 7201 Hewitt Associates Dr, Ste 500, Charlotte, NC 28262-4001 | 2010-07-27 |
| 1255587903 | Stuart Lee Schnider | General Practice | 3220 Latrobe Dr, Charlotte, NC 28211-4845 | 2008-08-13 |
| 1235184813 | Health-pro Mental Health Services Pllc | General Practice | 6700 Fairview Rd, Suite 420, Charlotte, NC 28210-3324 | 2006-05-23 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.