Provider Demographics
NPI:1740282698
Name:JAMES M. RHYNE, MD,PA
Entity type:Organization
Organization Name:JAMES M. RHYNE, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-873-5658
Mailing Address - Street 1:757 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4142
Mailing Address - Country:US
Mailing Address - Phone:704-873-5658
Mailing Address - Fax:704-873-5659
Practice Address - Street 1:757 BRYANT ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4142
Practice Address - Country:US
Practice Address - Phone:704-873-5658
Practice Address - Fax:704-873-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16001261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-71446Medicaid
NC71446OtherPROVIDER NUMBER
NC=========OtherTAX ID NUMBER
NC71446OtherPROVIDER NUMBER