CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY (NPI# 1770859126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770859126 |
| Entity Type | Organization |
| Organization Name | CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY |
| Other Organization Name | LEVINE CANCER INSTITUTE |
| Practice Address |
332 Sam Newell Rd Suite 2000 Matthews NC 28105-6566 |
| Mailing Address |
Po Box 602120 Charlotte NC 28260-2120 |
| Practice Telephone | 7043028500 |
| Practice Fax Number | 7043028501 |
| Mailing Telephone | 7043028500 |
| Mailing Fax Number | 7043028501 |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2013-06-24 |
| Authorized Official Name | PETER ACKER (ADMINISTRATOR) |
| Authorized Official Telephone | 9802121000 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5919627 | 05 | |
| SC | NPB470 | 05 |
| Other Name | Type Code |
|---|---|
| Levine Cancer Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841566106 | Charlotte Mecklenburg Hospital Authority | Internal Medicine | 16455 Statesville Rd, Suite 200, Huntersville, NC 28078-7135 | 2012-03-30 |
| 1043580681 | Charlotte Mecklenburg Hospital Authority | Internal Medicine | 411 Billingsley Rd, Suite 103, Charlotte, NC 28211-1046 | 2012-01-12 |
| 1700171766 | Charlotte Mecklenburg Hospital Authority | Pharmacy | 4525 Cameron Valley Pkwy, Suite 1200, Charlotte, NC 28211-4369 | 2011-06-17 |
| Street Address |
332 SAM NEWELL RD SUITE 2000 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124096953 | Kevyn Miller | Physician Assistant | 332 Sam Newell Rd, Suite 1100, Matthews, NC 28105-6566 | 2006-03-09 |
| 1346547809 | Carolinas Medical Center | Physical Medicine & Rehabilitation | 332 Sam Newell Rd, Suite 1200, Matthews, NC 28105-6566 | 2011-02-18 |
| 1699085605 | Carolinas Physicians Network Inc | Family Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2010-10-13 |
| 1710202163 | Mecklenburg Medical Group | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2010-03-29 |
| 1194854778 | Catherine Janell Tewolde | Nurse Practitioner | 332 Sam Newell Rd, Matthews, NC 28105-6566 | 2007-03-02 |
| 1568561330 | Leigh Sullivan Clavin | Pharmacist | 332 Sam Newell Rd, Matthews, NC 28105 | 2006-09-21 |
| 1790709210 | John E. Davenport | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750916771 | American Oncology Partners, Pa | Internal Medicine | 10 One Center Ct, Franklin, NC 28734-0095 | 2020-03-10 |
| 1215570890 | American Oncology Partners, P.a. | Internal Medicine | 1860 Sugar Hill Rd Ste A, Marion, NC 28752-5565 | 2019-10-25 |
| 1730658808 | Laura Kolker Max | Internal Medicine | 2301 Erwin Road Unit 9300, Durham, NC 27710-2621 | 2018-11-19 |
| 1396249256 | Deanna Andrews Griffie | Internal Medicine | 20 Medicine Circle Duke Cancer Center Clinic 3-2, Durham, NC 27710-0001 | 2018-03-23 |
| 1558885004 | Casey Marie Mozingo | Internal Medicine | 20 Duke Medicine Circle Duke Cancer, Durham, NC 27710-0001 | 2017-07-26 |
| 1710430822 | Angel Medical Center, Inc. | Internal Medicine | 834 Depot St, Franklin, NC 28734-0176 | 2016-07-26 |
| 1174942262 | Kristen Leigh Perez | Internal Medicine | 20 Duke Medicine Circle Duke Cancer Center Clinic 5-1, Durham, NC 27710-4699 | 2014-04-16 |
| 1851739239 | Jingquan Jia | Internal Medicine | 20 Duke Medicine Drive, Durham, NC 27710 | 2013-06-07 |
| 1215279617 | Jacob Eli Berchuck | Internal Medicine | 226 Chesley Ln, Chapel Hill, NC 27514-1461 | 2013-03-23 |
| 1861759391 | Wayne Dewitt Brenckman Jr. | Internal Medicine | 5632 Denwood Ln, Durham, NC 27705-9252 | 2012-04-22 |
| Find all providers with the same taxonomy | ||||
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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.