| Reserve Health, Pc | |
|
135 W 10th St Charlotte NC 28202 | |
| (704) 562-1613 | |
| Not Available |
| Full Name | Reserve Health, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 135 W 10th St, Charlotte, North Carolina |
| Authorized Official Name and Position | Daniel Biondi (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 7045621613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reserve Health, Pc 135 W 10th St Charlotte NC 28202 Ph: (704) 562-1613 | Reserve Health, Pc 135 W 10th St Charlotte NC 28202 Ph: (704) 562-1613 |
| NPI Number | 1659828291 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Medicare PECOS PAC ID | 2668754383 |
|---|---|
| Medicare Enrollment ID | O20170112002522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659828291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2006-01409 (North Carolina) | Primary |
| Provider Name | Laura A House |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114908647 PECOS PAC ID: 5799762563 Enrollment ID: I20040630000826 |
| Provider Name | Daniel T Biondi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558310078 PECOS PAC ID: 0749200160 Enrollment ID: I20061219000208 |
| Provider Name | Kenya E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588285480 PECOS PAC ID: 2062810203 Enrollment ID: I20211001002248 |
| Provider Name | Ieachia T Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003485699 PECOS PAC ID: 0042600710 Enrollment ID: I20211213000605 |
| Provider Name | Zachariah L Noltemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932810264 PECOS PAC ID: 0547633182 Enrollment ID: I20230302001400 |
| Provider Name | James E Granberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598333957 PECOS PAC ID: 5496114118 Enrollment ID: I20230628003949 |
| Provider Name | Kirby J Bandoquillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598150195 PECOS PAC ID: 1456653195 Enrollment ID: I20231207002044 |
| Provider Name | Amy Love Harvell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497414361 PECOS PAC ID: 8921452434 Enrollment ID: I20231214001728 |
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