DYNAMIC HEALTH MEDICAL GROUP PLLC (NPI# 1972085918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972085918 |
| Entity Type | Organization |
| Organization Name | DYNAMIC HEALTH MEDICAL GROUP PLLC |
| Practice Address |
4705 South Blvd Charlotte NC 28217 |
| Practice Telephone | 7045256288 |
| Practice Fax Number | 7045256384 |
| Mailing Telephone | 7045256288 |
| Mailing Fax Number | 7045256384 |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |
| Authorized Official Name | DIXIE WINSLOW (EXECUTIVE ASSISTANT) |
| Authorized Official Telephone | 7045256288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
4705 SOUTH BLVD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922668896 | Alisa Walker | Nurse Practitioner | 4705 South Blvd, Charlotte, NC 28217-2771 | 2019-06-13 |
| 1609334408 | Nakia Pinkney | Chiropractor | 4705 South Blvd, Charlotte, NC 28217-2771 | 2019-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| 1316483472 | Health Saver Rx, LLC | Pharmacy | 3809 Beam Road Suite H, Suite H, Charlotte, NC 28217 | 2017-01-13 |
| Find all providers in zip 28217 | ||||
| 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.