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PINE LAKE FAMILY MEDICINE
NPI 1215125919
Family Medicine in Matthews, NC

Active since October 09, 2007
4105 MATTHEWS MINT HILL RD, MATTHEWS, NC 28105(704) 545-4609(704) 545-4798 Get Directions Write a Review

NPPES record last updated: December 22, 2010. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Pine Lake Family Medicine NPPES

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

PINE LAKE FAMILY MEDICINE (NPI 1215125919) is a healthcare organization registered as a family medicine in Matthews, North Carolina and active in the NPI registry since October 2007. The organization lists Daniel L. Wiens, Senior Vice President Of Operations, as its authorized official.

NPPES Registry Identity

NPI1215125919
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCAROLINAS PHYSICIANS NETWORK INC.
Location Address4105 MATTHEWS MINT HILL RDMatthews, NC 28105-3633
Mailing AddressPo Box 601949Charlotte, NC 28260-1949 · (704) 545-4609 · Fax (704) 545-4798
Phone(704) 545-4609
Fax(704) 545-4798
Organization SubpartYesParent: Carolinas Physicians Network Inc
Authorized OfficialDaniel L. WiensSenior Vice President Of Operations · (704) 355-0648
Enumeration DateOctober 9, 2007
Last NPPES UpdateDecember 22, 2010
✔ NPI 1215125919 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.
4105 MATTHEWS MINT HILL RD, Matthews, NC 28105
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Other Names 1

Doing Business AsPine Lake Family Medicine

Other Identifiers 2

Medicaid5908365NC
Medicare PIN2334282ENC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONIA DAVIS BAILEY FNP
Nurse Practitioner
4105 MATTHEWS MINT HILL RD
MATTHEWS, NC 28105
Mecklenburg County (704) 316-3095
LAURA IBANEZ HERRERA
Physician Assistant
4105 MATTHEWS MINT HILL RD
MATTHEWS, NC 28105
Mecklenburg County (704) 316-3095
RONALD DESROUILLERES DO
Family Medicine
4105 MATTHEWS MINT HILL RD
MATTHEWS, NC 28105
Mecklenburg County (704) 316-3095
DR. BETH L CARLSON M.D.
Family Medicine
4105 MATTHEWS MINT HILL RD
MATTHEWS, NC 28105
Mecklenburg County (704) 384-9920
DR. KISHA ROCHELLE YOUNG M.D.
Family Medicine
4105 MATTHEWS MINT HILL RD
MINT HILL, NC 28105
Mecklenburg County (704) 384-9920
SEIJI BORJA FNP
Nurse Practitioner
4105 MATTHEWS MINT HILL RD
MATTHEWS, NC 28105
Mecklenburg County (704) 316-3095
NOVANT MEDICAL GROUP, INC.
Family Medicine
4105 MATTHEWS MINT HILL RD
MINT HILL, NC 28105
Mecklenburg County (704) 384-9920
DR. LLOYD BRIDGES M.D.
Family Medicine
4105 MATTHEWS MINT HILL RD
MINT HILL, NC 28105
Mecklenburg County (704) 384-9920

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 Carolinas Physicians Network Inc.'s NPI number?

The NPI number for Carolinas Physicians Network Inc. is 1215125919. It was assigned to this organization in the NPPES registry on October 9, 2007. The provider is doing business as Pine Lake Family Medicine.

Where is Carolinas Physicians Network Inc. located?

Carolinas Physicians Network Inc. is located at 4105 Matthews Mint Hill Rd, Matthews, NC 28105. The listed phone number is (704) 545-4609.

What is Carolinas Physicians Network Inc.'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 Carolinas Physicians Network Inc. was last updated on December 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.