DR. TIA RENE' KONZER D.O.
NPI 1477689578
Psychiatry & Neurology - Child & Adolescent Psychiatry in Charlotte, NC

Active since February 26, 2007Opted out of Medicare · through Jun 1, 2027
1900 RANDOLPH RD, CHARLOTTE, NC 28207(704) 384-1246(704) 384-6072 Get Directions Write a Review

NPPES record last updated: November 24, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Tia Rene' Konzer D.o. NPPES

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

DR. TIA RENE' KONZER D.O. (NPI 1477689578) is an individual child & adolescent psychiatry provider in Charlotte, North Carolina, licensed in North Carolina (2009-01442) and active in the NPI registry since February 2007. She has opted out of Medicare through June 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1477689578
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. TIA RENE' KONZERCredential: D.O.
Location Address1900 RANDOLPH RDCharlotte, NC 28207-1122
Mailing Address1900 Randolph RdCharlotte, NC 28207-1122 · (704) 384-1246 · Fax (704) 384-6072
Fax(704) 384-6072
Sole ProprietorNo
Enumeration DateFebruary 26, 2007
Last NPPES UpdateNovember 24, 2015
NPI 1477689578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License Licensed in NC · 2009-01442
Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 5101016063 (MI), 2009-01442 (NC)
1900 RANDOLPH RD, Charlotte, NC 28207

Other Identifiers 1

Medicaid5912201NC

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Tia Rene' Konzer D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 1, 2017 through June 1, 2027.

Opt-Out Effective DateJune 1, 2017
Opt-Out In Effect ThroughJune 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

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

Urology
1900 RANDOLPH RD, SUITE 310
CHARLOTTE, NC 28207
Physician Assistant (Medical)
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Psychiatry & Neurology (Neurology)
1900 RANDOLPH RD, SUITE 1010
CHARLOTTE, NC 28207
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477689578, enumerated as an "individual" on February 26, 2007.

The provider is located at 1900 RANDOLPH RD CHARLOTTE, NC 28207 and the phone number is (704) 384-1246.

Psychiatry & Neurology with taxonomy code 2084P0804X and a focus in Child & Adolescent Psychiatry.

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC, Medicare and. Please consult your insurance carrier or call the provider to verify.