CENTRAL CAROLINA MEDICAL CLINIC, PA (NPI# 1407271109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407271109 |
| Entity Type | Organization |
| Organization Name | CENTRAL CAROLINA MEDICAL CLINIC, PA |
| Other Organization Name | CENTRAL CAROLINA MEDICAL CLINIC, PA - PAW CREEK CENTER |
| Practice Address |
515 Little Rock Road Charlotte NC 28214 |
| Mailing Address |
6404 Albemarle Road Suite J & K Charlotte NC 28214 |
| Practice Telephone | 7045328884 |
| Practice Fax Number | 7045328789 |
| Mailing Telephone | 7045328884 |
| Mailing Fax Number | 7045328789 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |
| Authorized Official Name | TUONG NGUYEN (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 7045328884 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 2000-00566 | NC | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | 2008-00070 | NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Central Carolina Medical Clinic, PA - Paw Creek Center | Doing Business As Name - Organization |
| Street Address |
515 LITTLE ROCK ROAD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| 1104473974 | Daquan Ford | Technician | 7011 Hunters Glen Drive, Charlotte, NC 28214 | 2019-08-26 |
| 1457836736 | Miracle Houses, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7827 Kerry Brook Circle, Charlotte, NC 28214 | 2018-10-02 |
| 1912481029 | Charlotte Afriyie | Behavior Technician | 2122 Sonoma Valley Drive, Charlotte, NC 28214 | 2018-09-25 |
| 1588161350 | Future Impression | Counselor | 619 Sullivan Street, Charlotte, NC 28214 | 2018-04-09 |
| 1588072326 | Key Choice Counseling | Community/Behavioral Health | 2909 Berry Creek Rd., Charlotte, NC 28214 | 2014-07-24 |
| 1255751699 | Joyce Patterson Melton | Registered Nurse | 7409 Pawtuckett Rd, Charlotte, NC 28214 | 2014-04-24 |
| 1063764702 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 5917 Rowan Way, Charlotte, NC 28214 | 2012-10-04 |
| 1043569460 | Loretta Massey | Social Worker | 2202 Lisa Carole Drive, Charlotte, NC 28214 | 2012-08-30 |
| 1023327129 | Margaret Cynthia Stewart | Speech-Language Pathologist | 1805 Mt Isle Harbor Drive, Charlotte, NC 28214 | 2010-10-07 |
| Find all providers in zip 28214 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745985 | Alegis Care - North Carolina PC | Family Medicine | 11016 Rushmore Dr Ste 300, Charlotte, NC 28277-3651 | 2020-09-18 |
| 1902411077 | Carolina Medical Partners Pllc | Family Medicine | 10535 Flennigan Way, Charlotte, NC 28277-1417 | 2020-09-15 |
| 1083226906 | Relymd Medical Group Nc, Pllc | Family Medicine | 212 S Tryon St Ste 1000, Charlotte, NC 28281-0001 | 2020-08-21 |
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1881223139 | Renew Health and Wellness | Family Medicine | 9010 Glenwater Dr Ste 102, Charlotte, NC 28262-8593 | 2020-04-07 |
| 1164052957 | Partners In Integrated Healthcare & Wellness Pllc | Family Medicine | 9414b Albemarle Rd, Charlotte, NC 28227-3346 | 2020-01-21 |
| 1578103636 | Madelyn Laine Eudy | Family Medicine | 15640 Don Lochman Ln Ste A, Charlotte, NC 28277-4793 | 2020-01-07 |
| 1518514686 | L'renda Arkie Adams | Family Medicine | 8724 Bodkin Ct, Charlotte, NC 28215-7356 | 2019-08-22 |
| 1952956419 | Heather Marie Anderson | Family Medicine | 6404 Albemarle Rd Ste J&k, Charlotte, NC 28212-3800 | 2019-08-01 |
| 1003460213 | Companion Health, Pllc | Family Medicine | 5029 Lady Fern Cir, Charlotte, NC 28211-4182 | 2019-07-25 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on CENTRAL CAROLINA MEDICAL CLINIC, PA.
| 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.