1598779803 NPI number — NEPHROLOGY ASSOCIATES OF THE CAROLINAS, P.A.

Table of content: (NPI 1598779803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598779803 NPI number — NEPHROLOGY ASSOCIATES OF THE CAROLINAS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEPHROLOGY ASSOCIATES OF THE CAROLINAS, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598779803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1019 N LAFAYETTE ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
SHELBY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28150-3834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-487-9766
Provider Business Mailing Address Fax Number:
704-487-9891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1019 N LAFAYETTE ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-487-9766
Provider Business Practice Location Address Fax Number:
704-487-9891
Provider Enumeration Date:
07/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AHMED
Authorized Official First Name:
SYED
Authorized Official Middle Name:
JAWED
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
704-487-9766

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 89138FJ , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131EE . This is a "BCBS IQBAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89131EE , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0114Q . This is a "BCBS GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10431 . This is a "BCBS AHMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8910431 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138FJ . This is a "BCBS ALAM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 890114Q , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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