| Mecklenburg Neurology Group | |
|
70 Lake Concord Rd Ne Concord NC 28025-3057 | |
| (980) 777-8311 | |
| (980) 777-8274 |
| Full Name | Mecklenburg Neurology Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 70 Lake Concord Rd Ne, Concord, North Carolina |
| Authorized Official Name and Position | Michael M Amiri (MD) |
| Authorized Official Contact | 7048399268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mecklenburg Neurology Group 70 Lake Concord Rd Ne Concord NC 28025-3057 Ph: (980) 777-8311 | Mecklenburg Neurology Group 70 Lake Concord Rd Ne Concord NC 28025-3057 Ph: (980) 777-8311 |
| NPI Number | 1417446691 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 02/21/2022 |
| Certification Date | 02/10/2022 |
| Medicare PECOS PAC ID | 4385999408 |
|---|---|
| Medicare Enrollment ID | O20180613002493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417446691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | 9400705 (North Carolina) | Primary |
| Provider Name | Robert A Nahouraii |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104877224 PECOS PAC ID: 1153336532 Enrollment ID: I20060207000750 |
| Provider Name | John G Rancy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164488631 PECOS PAC ID: 5597785592 Enrollment ID: I20080128000308 |
| Provider Name | Michael M Amiri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720161011 PECOS PAC ID: 0446325625 Enrollment ID: I20080822000351 |
| Provider Name | Betty C Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881913382 PECOS PAC ID: 6507998093 Enrollment ID: I20100720000045 |
| Provider Name | Kelly Y Xiong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740670702 PECOS PAC ID: 9032428552 Enrollment ID: I20151023002318 |
| Provider Name | Matthew Wells Mcconnell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699018044 PECOS PAC ID: 7416185210 Enrollment ID: I20190808002723 |
| Provider Name | Drew Morgan Bolyard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679129639 PECOS PAC ID: 7810229267 Enrollment ID: I20191104002967 |
| Provider Name | Autumn Christine Grimm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265031413 PECOS PAC ID: 4880005636 Enrollment ID: I20201130001010 |
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