SOUTH LAKE PEDIATRICS (NPI# 1295766079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295766079 |
| Entity Type | Organization |
| Organization Name | SOUTH LAKE PEDIATRICS |
| Other Organization Name | SOUTH LAKE PEDIATRICS |
| Practice Address |
9625 Northcross Center Ct Ste 201 Huntersville NC 28078-7348 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7048013097 |
| Mailing Telephone | 7046310002 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | THOMAS LAYMON (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7044468250 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH LAKE PEDIATRICS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| South Lake Pediatrics | Doing Business As Name - Organization |
| South Lake Pediatrics | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755610 | South Lake Pediatrics | Pediatrics | 1585 Forney Creek Pkwy, Ste 2100, Denver, NC 28037-9514 | 2018-10-08 |
| 1619203791 | South Lake Pediatrics | Pediatrics | 9908 Couloak Dr, Ste 103, Charlotte, NC 28216-8678 | 2009-10-26 |
| Street Address |
9625 NORTHCROSS CENTER CT STE 201 |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-7348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598131575 | Southlake Family and Cosmetic Dentistry | Dentist | 9625 Northcross Center Ct, Huntersville, NC 28078-7348 | 2015-08-13 |
| 1760810501 | Charlotte-mecklenburg Hospital Authority | Internal Medicine | 9625 Northcross Center Ct, Suite 102, Huntersville, NC 28078-7348 | 2013-10-14 |
| 1376970418 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 9625 Northcross Center Ct, Suite 102g, Huntersville, NC 28078-7348 | 2013-10-03 |
| 1225465362 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 9625 Northcross Center Ct, Suite 102b, Huntersville, NC 28078-7348 | 2013-10-03 |
| 1962839068 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 9625 Northcross Center Ct, Ste 102d, Huntersville, NC 28078-7348 | 2013-10-03 |
| 1902233380 | The Charlotte-mecklenburg Hospital Authority | Pediatrics | 9625 Northcross Center Ct, Ste 102c, Huntersville, NC 28078-7348 | 2013-10-01 |
| 1801223482 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 9625 Northcross Center Ct, Ste 102e, Huntersville, NC 28078-7348 | 2013-09-27 |
| 1629405212 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 9625 Northcross Center Ct, Ste 102, Huntersville, NC 28078-7348 | 2013-09-27 |
| 1548608292 | Steven Hayes | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2013-06-04 |
| 1376989061 | Carolinas Medical Center-northeast | Pediatrics | 9625 Northcross Center Ct, Suite 102-g, Huntersville, NC 28078-7348 | 2013-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104908409 | Victoria Garriett-lampkin | Pediatrics | 6055 Latta Springs Cir, Huntersville, NC 28078-2333 | 2006-10-19 |
| 1215454053 | Novant Medical Group, Inc | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078-7217 | 2017-08-23 |
| 1548608292 | Steven Hayes | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2013-06-04 |
| 1134412406 | Jill Hopkins | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2011-05-19 |
| 1164659322 | Karen Elizabeth Lewis | Pediatrics | 17220 Northcross Dr Ste 110, Huntersville, NC 28078-5076 | 2009-06-15 |
| 1083875355 | Mary Davis | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2008-06-19 |
| 1083784565 | Marcia Rubinos | Pediatrics | 9625 Northcross Center Ct, Ste 201, Huntersville, NC 28078-7348 | 2006-11-09 |
| 1578676979 | Charles Andrew Little | Pediatrics | 10305 Hamptons Park Dr Ste 101, Huntersville, NC 28078 | 2006-08-17 |
| 1689698474 | Michelle Brody | Pediatrics | 9625 Northcross Center Ct, Suite 201, Huntersville, NC 28078-7348 | 2006-07-26 |
| 1932123726 | John Burcal | Pediatrics | 9625 Northcross Center Ct, Suite 201, Huntersville, NC 28078-7348 | 2006-07-26 |
| Find all providers in HUNTERSVILLE | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.