MECKLENBURG MEDICAL GROUP (NPI# 1457677247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457677247 |
| Entity Type | Organization |
| Organization Name | MECKLENBURG MEDICAL GROUP |
| Practice Address |
1900 Brunswick Ave Charlotte NC 28207-1822 |
| Mailing Address |
Po Box 601643 Charlotte NC 28260-1643 |
| Practice Telephone | 7043584400 |
| Practice Fax Number | 7043386577 |
| Mailing Telephone | 7043584400 |
| Mailing Fax Number | 7043386577 |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2017-09-12 |
| Authorized Official Name | MR. THOMAS FORD LAYMON (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7044468250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RB0002X |
Internal Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89013PP | 05 | |
| SC | E08621 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669797536 | Mecklenburg Medical Group | Internal Medicine | 16455 Statesville Road, Suite 200, Huntersville, NC 28078-7125 | 2010-04-02 |
| 1518282581 | Mecklenburg Medical Group | Internal Medicine | 7666 Charlotte Highway, Suite 200, Indian Land, SC 29707-7001 | 2010-04-02 |
| 1831414705 | Mecklenburg Medical Group | Internal Medicine | 10650 Park Road Extension, Suite 420, Charlotte, NC 28210-8539 | 2010-04-02 |
| 1780909101 | Mecklenburg Medical Group | Internal Medicine | 15110 John J Delaney Drive, Suite 200, Charlotte, NC 28277-3545 | 2010-03-29 |
| 1629305073 | Mecklenburg Medical Group | Internal Medicine | 13640 Steelecroft Parkway, Suite 320, Charlotte, NC 28278-7565 | 2009-11-05 |
| 1477879260 | Mecklenburg Medical Group | Dermatology | 4525 Cameron Valley Pkwy, Suite 2100, Charlotte, NC 28211-4369 | 2010-04-19 |
| 1821314618 | Mecklenburg Medical Group | Internal Medicine | 200 South College Street, Suite 500, Charlotte, NC 28202-2067 | 2010-04-19 |
| 1093031882 | Mecklenburg Medical Group | Internal Medicine | 16455 Statesville Rd, Ste 200, Huntersville, NC 28078-7135 | 2010-04-19 |
| 1366768152 | Mecklenburg Medical Group | Dermatology | 1025 Morehead Medical Drive, Suite 200, Charlotte, NC 28204-2965 | 2010-04-19 |
| 1700102506 | Mecklenburg Medical Group | Internal Medicine | 10650 Park Rd, Ste 420, Charlotte, NC 28210-8538 | 2010-04-19 |
| Street Address |
1900 BRUNSWICK AVE |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083652705 | Dominique Falewee | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2006-06-03 |
| 1669797189 | Carolinas Physicians Network Inc | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2010-03-29 |
| 1144545583 | Mecklenburg Medical Group | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2010-03-29 |
| 1265656094 | Glen Fandetti | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2007-04-12 |
| 1982793717 | Sarah Jane Massey | Nurse Practitioner | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2006-10-12 |
| 1922117191 | Kenneth D. Owen Jr. | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2006-08-30 |
| 1124061569 | Frank Valeri | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2006-06-14 |
| 1922041425 | William Bock | Internal Medicine | 1900 Brunswick Ave, Charlotte, NC 28207-1822 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 207RB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063774461 | Melody Covington | Internal Medicine | 6135 Park South Dr Ste 510, Charlotte, NC 28210-0100 | 2012-06-12 |
| 1629516067 | Novant Medical Group, Inc | Internal Medicine | 14215 Ballantyne Corporate Pl, Suite 240, Charlotte, NC 28277-3670 | 2017-02-06 |
| 1316245475 | Novant Medical Group, Inc | Internal Medicine | 15825 John J Delaney Dr, Suite 220, Charlotte, NC 28277-3147 | 2011-03-14 |
| 1982935805 | Novant Medical Group Inc | Internal Medicine | 2300 Randolph Rd, Ste A, Charlotte, NC 28207-1586 | 2010-01-15 |
| 1861671463 | Carolinas Physicians Network Inc | Internal Medicine | 2630 E 7th St, Charlotte, NC 28204-4318 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346627973 | Novant Medical Group, Inc. | Internal Medicine | 1710 Kernersville Medical Pkwy Ste 210, Kernersville, NC 27284-7157 | 2015-05-04 |
| 1093141392 | Novant Medical Group, Inc | Internal Medicine | 1910 Jake Alexander Blvd W Ste 201, Salisbury, NC 28147-1165 | 2013-09-18 |
| 1023319449 | Novant Medical Group, Inc | Internal Medicine | 911 West Henderson Street, Kiser Building, Suite 410, Salisbury, NC 28144-2700 | 2010-11-17 |
| 1013571587 | Wakemed Specialists Group, LLC | Internal Medicine | 160 Macgregor Pines Dr, Cary, NC 27511-6036 | 2019-04-30 |
| 1932659901 | Novant Medical Group, Inc | Internal Medicine | 5701 W Friendly Ave, Greensboro, NC 27410-4112 | 2016-10-13 |
| 1134594013 | Regional Physicians LLC | Internal Medicine | 300 Gatewood Ave, High Point, NC 27262 | 2015-12-03 |
| 1538545090 | Mission Medical Associates Inc | Internal Medicine | 360 Hospital Dr, Clyde, NC 28721-0107 | 2015-08-07 |
| 1487051298 | Mission Medical Associates Inc. | Internal Medicine | 430 Rankin Dr, Marion, NC 28752-6568 | 2014-11-21 |
| 1316344229 | Mission Medical Associates Inc | Internal Medicine | 260 Hospital Dr, Brevard, NC 28712-3378 | 2014-11-21 |
| 1578960381 | Mission Medical Associates Inc. | Internal Medicine | 120 Riverview St, Franklin, NC 28734-2612 | 2014-11-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MECKLENBURG MEDICAL GROUP.
| 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.