Cannercharles Pllc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Corolla, North Carolina. The current practice location for Cannercharles Pllc is 1129 Corolla Village Rd C, Corolla, North Carolina. For appointments, you can reach them via phone at
(252) 597-1157. The mailing address for Cannercharles Pllc is 1201 Lake James Dr Ste 200, Virginia Beach, Virginia and phone number is (757) 523-0022.
Cannercharles Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1215755764. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(252) 597-1157.
Primary Care Clinic Profile
| Full Name | Cannercharles Pllc |
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| Speciality | Clinic/Center |
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| Location | 1129 Corolla Village Rd C, Corolla, North Carolina |
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| Authorized Official Name and Position | Emily Krauter (BILLING MANAGER) |
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| Authorized Official Contact | 7575230022 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Cannercharles Pllc
1201 Lake James Dr Ste 200
Virginia Beach
VA 23464-6780
Ph: (757) 523-0022 | Cannercharles Pllc
1129 Corolla Village Rd C
Corolla
NC 27927
Ph: (252) 597-1157 |
NPI Details:
| NPI Number | 1215755764 |
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| Provider Enumeration Date | 10/02/2024 |
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| Last Update Date | 10/02/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 8729504782 |
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| Medicare Enrollment ID | O20250502000913 |
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Medical Identifiers
Medical identifiers for Cannercharles Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215755764 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Cannercharles Pllc acts as a billing entity for following providers:
| Provider Name | Robert C Blackwood |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1407841968
PECOS PAC ID: 4587616867
Enrollment ID: I20250502001012 |
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