CHARLES A BLOTNICK (NPI# 1457320020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457320020 |
| Entity Type | Individual |
| Full Name | CHARLES A BLOTNICK |
| Credential | M.D. |
| Practice Address |
2015 Randolph Rd Suite 108 Charlotte NC 28207-1200 |
| Mailing Address |
1615 Hugh Forest Rd Charlotte NC 28270-3446 |
| Practice Telephone | 7043342020 |
| Practice Fax Number | 7043346175 |
| Mailing Telephone | 7043342020 |
| Mailing Fax Number | 7043346175 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 21278 | SC | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 9901116 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 891229K | 05 | |
| SC | 212781 | 05 |
| Street Address |
2015 RANDOLPH RD SUITE 108 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493239 | William Alfred Walker | Colon & Rectal Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1200 | 2005-11-04 |
| 1508294687 | Jacquelyn Chandler Rupp | Dietitian, Registered | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2013-10-28 |
| 1356779169 | Charlotte Gastroenterology & Hepatology | Dietitian, Registered | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2013-10-15 |
| 1083959282 | Novant Medical Group, Inc | Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1200 | 2012-11-29 |
| 1851548655 | Charlotte Gastroenterology & Hepatology, Pllc | Clinic/Center | 2015 Randolph Rd, Suite 101, Charlotte, NC 28207-1128 | 2008-08-22 |
| 1902934755 | Robert Stevens | Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1128 | 2007-03-02 |
| 1073603486 | Jason A Wilson | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2006-10-14 |
| 1730100801 | Charlotte Gastroenterology & Hepatology, Pllc | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2006-07-22 |
| 1003854860 | Marcie Lynne Pickett | Nurse Practitioner | 2015 Randolph Rd, Ste 208, Charlotte, NC 28207-1200 | 2006-06-03 |
| 1285682443 | David G Scholz | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1200 | 2006-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114572534 | Charlotte Eye Ear Nose & Throat Associates, Pa | Ophthalmology | 400 E Stonewall St Unit F, Charlotte, NC 28202-3601 | 2019-08-02 |
| 1518351493 | Lee Angelo Wiley | Ophthalmology | 10512 Park Rd Ste 200, Charlotte, NC 28210-8476 | 2015-03-27 |
| 1710271507 | Charlotte Eye Ear Nose & Throat Associates, Pa | Ophthalmology | 2614 E 7th St, Charlotte, NC 28204-4375 | 2011-06-09 |
| 1760633812 | Pedro Cervantes Fanning | Ophthalmology | 13532 Steelecroft Parkway, Charlotte, NC 28278-7545 | 2008-10-07 |
| 1548290562 | Reza Michael Mozayeni | Ophthalmology | 3025 Springbank Lane, Ste 200, Charlotte, NC 28226-3362 | 2006-07-04 |
| 1821026980 | Thomas K Mundorf | Ophthalmology | 1718 E. Fourth St., Ste 703, Charlotte, NC 28204 | 2006-06-29 |
| 1720027543 | Cleve Wilson Howard | Ophthalmology | 7530 Whistlestop Rd, Charlotte, NC 28210-6914 | 2006-06-06 |
| 1669428975 | Galen Grayson | Ophthalmology | 817 E Morehead St, Ste 200, Charlotte, NC 28202-2700 | 2006-05-26 |
| 1013963719 | Genesis Eye Center | Ophthalmology | 817 East Morehead Street, Suite 200, Charlotte, NC 28202-2767 | 2006-05-25 |
| 1851354724 | Wesley Dobbs Clement Sr. | Ophthalmology | 230 E Wt Harris Blvd, Suite C-13, Charlotte, NC 28262-3492 | 2006-04-10 |
| Find all providers in CHARLOTTE | ||||
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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.