NPIMap

Organization Active NPI

Carolina Digestive Health Associates, PA

Doing business as Carolina Digestive Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
National Provider Identifier
1063584415
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA
Doing business as
Carolina Digestive Endoscopy Center
Practice address
300 Billingsley Road
Suite 200B
Charlotte, NC 28211-3092
Phone
(704) 372-7974
Fax
(704) 372-4966
NPI assigned
Nov 14, 2006
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINA DIGESTIVE HEALTH ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Julie Rothrock
Title
Credentialing Coordinator
Phone
(704) 372-7974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

300 Billingsley Road
Suite 200B
Charlotte, NC 28211-3092

Mailing address

PO Box 96314
Charlotte, NC 28296-0314
Phone (704) 372-7974

Other names 1

  • Carolina Digestive Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070322000596 NC Part B Supplier - Ambulatory Surgical Center 1951209790 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Carolina Digestive Endoscopy CenterCCN 34C0001136
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1057422Carolina Digestive Endoscopy Center300 Billingsley Road Suite 200B, Charlotte, NC 28211Certificate of waiverAug 10, 2026

National Provider Directory

National Provider Directory
Part of
Carolina Digestive Health Associates PA

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

300 Billingsley Rd
Ste 200
Charlotte, NC 28211
Phone (704) 372-3350

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1063584415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96314",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282960314",
            "telephone_number": "704-372-7974",
            "fax_number": "704-970-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BILLINGSLEY ROAD",
            "address_2": "SUITE 200B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113092",
            "telephone_number": "704-372-7974",
            "fax_number": "704-372-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "ROTHROCK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "704-372-7974"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Digestive Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Digestive Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.