NPIMap

Organization Active NPI

Perioperative Services, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1023323128
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PERIOPERATIVE SERVICES, LLC
Practice address
1822 Brunswick Ave
Charlotte, NC 28207-1820
Phone
(704) 831-3100
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Mary S Cloninger
Title
Executive Director
Phone
(704) 831-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1822 Brunswick Ave
Charlotte, NC 28207-1820

Mailing address

1822 Brunswick Ave
Charlotte, NC 28207-1820
Phone (704) 831-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100909000830 NC Part B Supplier - Clinic/Group Practice 1951426246 Receives reassigned benefits from 29 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1822 Brunswick Ave
Charlotte, NC 28207
Phone (704) 342-4323

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1023323128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 BRUNSWICK AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071820",
            "telephone_number": "704-831-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 BRUNSWICK AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071820",
            "telephone_number": "704-831-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIOPERATIVE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "CLONINGER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-831-3100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.