| Charlotte Community Health Clinic, Inc. | |
|
8401 Medical Plaza Dr Ste 300 Charlotte NC 28262-8702 | |
| (704) 316-6574 | |
| (704) 384-1977 |
| Full Name | Charlotte Community Health Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8401 Medical Plaza Dr Ste 300, Charlotte, North Carolina |
| Authorized Official Name and Position | Carolyn C Allison (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7043166561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlotte Community Health Clinic, Inc. 8401 Medical Plaza Dr Ste 300 Charlotte NC 28262-8702 Ph: (704) 316-6561 | Charlotte Community Health Clinic, Inc. 8401 Medical Plaza Dr Ste 300 Charlotte NC 28262-8702 Ph: (704) 316-6574 |
| NPI Number | 1528363868 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 10/08/2020 |
| Medicare PECOS PAC ID | 0840502274 |
|---|---|
| Medicare Enrollment ID | O20150626001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528363868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Hilary L Canipe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225059884 PECOS PAC ID: 8325081664 Enrollment ID: I20050607000917 |
| Provider Name | Daphne K Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518012350 PECOS PAC ID: 6002985132 Enrollment ID: I20080516000153 |
| Provider Name | Sveta Mohanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316023336 PECOS PAC ID: 5193913655 Enrollment ID: I20101228000182 |
| Provider Name | Lisa A Langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457693426 PECOS PAC ID: 4981842606 Enrollment ID: I20130607000182 |
| Provider Name | Andrea Simmons Rice |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801962246 PECOS PAC ID: 6800194457 Enrollment ID: I20160414000696 |
| Provider Name | Raymond Tanwani Tah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518482710 PECOS PAC ID: 0345516761 Enrollment ID: I20171030001125 |
| Provider Name | Tiffany Gail Byerly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922535012 PECOS PAC ID: 6800166158 Enrollment ID: I20200723001834 |
| Provider Name | Amanda Renee Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902421365 PECOS PAC ID: 7214356633 Enrollment ID: I20201002001887 |
| Provider Name | Lubabatu Inuwa Maimai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124635586 PECOS PAC ID: 7113346412 Enrollment ID: I20201007000036 |
| Provider Name | Brandy Jo Sampson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770191835 PECOS PAC ID: 7416367867 Enrollment ID: I20201113001381 |
| Provider Name | Rachael Vaughn Pennell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285087031 PECOS PAC ID: 5395143671 Enrollment ID: I20211018002645 |
| Provider Name | Harold T Zeltner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508955980 PECOS PAC ID: 7416047303 Enrollment ID: I20211022000317 |
| Provider Name | Alagusivakumari Rameshbabu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003850389 PECOS PAC ID: 9739071341 Enrollment ID: I20220512002809 |
| Provider Name | Amy K Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821342536 PECOS PAC ID: 4587880026 Enrollment ID: I20221021002088 |
| Provider Name | Mallori Njeri Watson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1417268038 PECOS PAC ID: 8820216955 Enrollment ID: I20230330001088 |
| Provider Name | Heather L Bartlett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003554411 PECOS PAC ID: 4385019470 Enrollment ID: I20230403001090 |
| Provider Name | Brittanie Almitra Height |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427794775 PECOS PAC ID: 6002272861 Enrollment ID: I20230519002765 |
| Provider Name | Nga Tran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043847049 PECOS PAC ID: 8325469257 Enrollment ID: I20230726003481 |
| Provider Name | Neo Mamoraka Ehiwe |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942947858 PECOS PAC ID: 6901268911 Enrollment ID: I20230808001875 |
| Provider Name | Yuliya Rudnitsky Olson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508379611 PECOS PAC ID: 8224486063 Enrollment ID: I20231205000057 |
Novant Health Infectious Disease Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Randolph Rd, Suite 216, Charlotte, NC 28207 Phone: 704-384-5416 Fax: 704-384-5996 | |
Atrium Health Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10660 Park Rd, Ste 4400, Charlotte, NC 28210 Phone: 704-355-0607 | |
Amity Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6010 E W T Harris Blvd, Charlotte, NC 28215 Phone: 704-208-4134 Fax: 704-248-8068 | |
Companion Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5029 Lady Fern Cir, Charlotte, NC 28211 Phone: 704-236-2658 | |
Novant Health Carolina Family Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7110 Lawyers Rd, Charlotte, NC 28227 Phone: 704-537-0020 Fax: 704-316-8634 | |
Kent Seitz Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1421 Orchard Lake Drive, Suite C, Charlotte, NC 28270 Phone: 704-844-0181 Fax: 904-701-6279 | |
Health And Wellness Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 E 5th St, Suite 214, Charlotte, NC 28202 Phone: 704-909-7954 |