| Dynamic Health Carolinas, Pllc | |
|
4705 South Blvd. Charlotte NC 28217-2771 | |
| (704) 525-6288 | |
| (704) 525-6384 |
| Full Name | Dynamic Health Carolinas, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 4705 South Blvd., Charlotte, North Carolina |
| Authorized Official Name and Position | Dixie Winslow (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 7045256288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Health Carolinas, Pllc 4705 South Blvd. Charlotte NC 28217-2771 Ph: (704) 525-6288 | Dynamic Health Carolinas, Pllc 4705 South Blvd. Charlotte NC 28217-2771 Ph: (704) 525-6288 |
| NPI Number | 1124693338 |
|---|---|
| Provider Enumeration Date | 05/21/2021 |
| Last Update Date | 05/21/2021 |
| Medicare PECOS PAC ID | 9537569868 |
|---|---|
| Medicare Enrollment ID | O20210608002993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124693338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Secondary |
| Provider Name | James M Patton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518945690 PECOS PAC ID: 2062495773 Enrollment ID: I20040611000937 |
| Provider Name | Alisa L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922668896 PECOS PAC ID: 9335476340 Enrollment ID: I20190814002048 |
| Provider Name | Logan Dean Evans |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1164776183 PECOS PAC ID: 5193966885 Enrollment ID: I20200903002507 |
| Provider Name | James Hughes |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1063055697 PECOS PAC ID: 0042622581 Enrollment ID: I20201208000024 |
| Provider Name | Danielle Marie Crum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457941007 PECOS PAC ID: 5294149217 Enrollment ID: I20210202001571 |
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