| |
309 S Sharon Amity Rd Ste 100 Charlotte NC 28211-2978 | |
(704) 446-2360 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 309 S Sharon Amity Rd, Charlotte, North Carolina |
Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
Authorized Official Contact | 7043558675 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | 309 S Sharon Amity Rd Ste 100 Charlotte NC 28211-2978 Ph: (704) 446-2360 |
NPI Number | 1083642169 |
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Provider Enumeration Date | 06/29/2006 |
Last Update Date | 03/09/2023 |
Medicare PECOS PAC ID | 7911978218 |
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Medicare Enrollment ID | O20040802000801 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083642169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Susan M Stephen Lester |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1073513388 PECOS PAC ID: 5799759825 Enrollment ID: I20050822000188 |
Provider Name | Daniel L Rosenberg |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427151851 PECOS PAC ID: 4688676612 Enrollment ID: I20070205000349 |
Provider Name | Jessica P Ignash |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720497571 PECOS PAC ID: 4284855925 Enrollment ID: I20141022002589 |
Provider Name | Emily Haynes Cooper |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679602957 PECOS PAC ID: 3870647621 Enrollment ID: I20150114002517 |
Provider Name | Joann Tao |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972920809 PECOS PAC ID: 3274755970 Enrollment ID: I20171114001680 |
Provider Name | Phiyen Nguyen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962994558 PECOS PAC ID: 1759630213 Enrollment ID: I20180817000089 |
Provider Name | Matthew James Poplin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407352727 PECOS PAC ID: 0840548319 Enrollment ID: I20210730001528 |
Provider Name | Katherine N Howdy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780300186 PECOS PAC ID: 5496100711 Enrollment ID: I20240418000436 |
Provider Name | Julia Katherine Shuster |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841853785 PECOS PAC ID: 2860728268 Enrollment ID: I20240912001795 |
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 | |
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 |