SIR FUNCHESS JR. (NPI# 1740407303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740407303 |
| Entity Type | Individual |
| Full Name | SIR FUNCHESS JR. |
| Credential | PA |
| Practice Address |
9332 S Tryon St Charlotte NC 28273-3108 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7045876700 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-01320 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA914 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5717 Albemarle Rd, Charlotte, NC 282121634 | 7045632150 | |
| 5727 Prosperity Crossing Dr, Ste 1100, Charlotte, NC 282692206 | 7048639930 | |
| 704 Gold Hill Rd, Ste 1200, Fort Mill, SC 297158906 | 7046673380 | |
| 7810 Providence Rd, Ste 102, Charlotte, NC 282262954 | 7045436636 |
| Street Address |
9332 S TRYON ST |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28273-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144291410 | Ayanna Galloway | Physician Assistant | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2006-01-27 |
| 1386182756 | Jennifer Lopez | Nurse Practitioner | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2017-02-06 |
| 1740605666 | Stephanie Jones | Nurse Practitioner | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2014-02-28 |
| 1699089862 | Stacia Tate | Nurse Practitioner | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2010-07-30 |
| 1871814160 | Theresa Smith | Nurse Practitioner | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2010-06-21 |
| 1699004697 | Carolinas Physicians Network Inc | Pediatrics | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2009-12-22 |
| 1528397593 | Palmetto Pediatrics | Pediatrics | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2009-12-21 |
| 1316198229 | Peter Nkyesiga | Physician Assistant | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2008-10-09 |
| 1902959315 | Debbie Rutledge-holt | Physician Assistant | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2007-01-19 |
| 1942229661 | Jerry Withrow | Family Medicine | 9332 S Tryon St, Charlotte, NC 28273-3108 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588204846 | Amerita South Atlantic LLC | Durable Medical Equipment & Medical Supplies | 2520 Whitehall Park Dr Ste 1000, Charlotte, NC 28273 | 2020-01-14 |
| 1295387637 | Excel Eyecare Od Pa | Optometrist | 14154 Steele Creek Rd, Ste 200, Charlotte, NC 28273 | 2019-07-16 |
| 1992262018 | Katherine Grace Bias | Speech-Language Pathologist | 11709 Freuhaud Dr Ste. 123, Charlotte, NC 28273 | 2019-02-25 |
| 1487111977 | Shanise Danielle Lewis | Respite Care | Top Notch Nurse Staffing & Home Health LLC., 2015 Ayrsley Town Blvd. Suite 202, Charlotte, NC 28273 | 2019-02-21 |
| 1700361953 | Timothy John Hartman | Chiropractor | 2550 West Arrowood Road Suite 104, Charlotte, NC 28273 | 2018-10-03 |
| 1144703141 | Shaquanda King | Behavior Technician | 15528 Baltinglass Ct., Charlotte, NC 28273 | 2018-09-14 |
| 1184106502 | Janelle Gillis | Behavioral Analyst | 13354 Calloway Glen Dr, Charlotte, NC 28273 | 2018-09-01 |
| 1730688680 | Style By Shandy Inc | Specialist | 2106 Arysley Town Blvd, A, Charlotte, NC 28273 | 2018-02-06 |
| 1063945582 | Bpolloni Consulting | Clinical Medical Laboratory | 11709 Fruehauf Drive, Suite 105 & 106, Charlotte, NC 28273 | 2017-04-11 |
| 1770038325 | Kerry Barbera | Dietitian, Registered | 12421 Belmont Mansion Dr, Charlotte, NC 28273 | 2016-08-23 |
| Find all providers in zip 28273 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351607 | Michael James Blackwell | Physician Assistant | 501 Billingsley Rd Ste B, Charlotte, NC 28211-1009 | 2020-09-22 |
| 1598371320 | Jonathan Byron Lively | Physician Assistant | 1000 Blythe Blvd Fl 3, Charlotte, NC 28203-5812 | 2020-09-17 |
| 1902415532 | Jacqueline Ellen Leyrer | Physician Assistant | 2630 E 7th St Ste 200, Charlotte, NC 28204-4319 | 2020-07-29 |
| 1750908380 | Whitney Debroy | Physician Assistant | 125 W Tremont Ave Unit 726, Charlotte, NC 28203-5551 | 2020-06-30 |
| 1972129302 | Ashley Nicole Short | Physician Assistant | 1022 E Worthington Ave, Charlotte, NC 28203-5760 | 2020-06-22 |
| 1558985176 | Courtney Claugus | Physician Assistant | 300 E Park Ave Unit 7, Charlotte, NC 28203-4774 | 2020-05-29 |
| 1467071738 | Patrick James Quinn | Physician Assistant | 2036 Millerton Ave Apt 4311, Charlotte, NC 28208-5290 | 2020-04-15 |
| 1225660301 | Sunil Ranchhod Ghodasara | Physician Assistant | 1001 Blythe Blvd Ste 403, Charlotte, NC 28203-5863 | 2020-02-06 |
| 1225668601 | Emily Rebecca Markey | Physician Assistant | 355 W Mlk Blvd Apt 1112, Charlotte, NC 28202-0043 | 2020-01-24 |
| 1639719586 | Abosede Elizabeth Adamson | Physician Assistant | 3101 Amesbury Hill Dr, Charlotte, NC 28269-8951 | 2020-01-08 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on SIR FUNCHESS JR..
| 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.