1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Family Medicine
  6. NPI Profile

KODIAK MEDICAL PA
NPI 1134872252
Family Medicine in Charlotte, NC

Active since January 28, 2022
10926 DAVID TAYLOR DR STE 120-105, CHARLOTTE, NC 28262(888) 566-4201 Get Directions Write a Review

NPPES record last updated: May 20, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: May 20, 2022, Jan 28, 2022 (2 updates tracked since 2022).

About Kodiak Medical Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KODIAK MEDICAL PA (NPI 1134872252) is a healthcare organization registered as a family medicine in Charlotte, North Carolina and active in the NPI registry since January 2022. The organization lists Sachin Surendra Mody, Owner, as its authorized official.

NPPES Registry Identity

NPI1134872252
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKODIAK MEDICAL PA
Location Address10926 DAVID TAYLOR DR STE 120-105Charlotte, NC 28262-1293
Mailing Address10926 David Taylor Dr Ste 120-105Charlotte, NC 28262-1293 · (888) 566-4201
Phone(888) 566-4201
Organization SubpartNo
Authorized OfficialSachin Surendra ModyOwner · (855) 837-8808
Enumeration DateJanuary 28, 2022
Last NPPES UpdateMay 20, 20222 updates tracked since enumeration
NPPES CertifiedMay 20, 2022
✔ NPI 1134872252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
10926 DAVID TAYLOR DR STE 120-105, Charlotte, NC 28262
Open in Google Maps ↗

Other Identifiers 1

Medicaid1134872252NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kodiak Medical PA's NPI number?

The NPI number for Kodiak Medical PA is 1134872252. It was assigned to this organization in the NPPES registry on January 28, 2022.

Where is Kodiak Medical PA located?

Kodiak Medical PA is located at 10926 David Taylor Dr Ste 120-105, Charlotte, NC 28262. The listed phone number is (888) 566-4201.

What is Kodiak Medical PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Kodiak Medical PA was last updated on May 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.