NPIMap

Organization Active NPI

Presbyterian Sameday Surgery Center at Huntersville LLC

Doing business as Novant Health Huntersville Outpatient Surgery

  • Ambulatory Surgical Clinic/Center
  • Huntersville, NC
National Provider Identifier
1063641801
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC
Doing business as
Novant Health Huntersville Outpatient Surgery
Practice address
10030 Gilead Road
Huntersville, NC 28078
Phone
(704) 316-4010
Fax
(704) 316-6706
NPI assigned
Jul 14, 2009
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Fred M Hargett
Title
Cfo
Phone
(704) 384-5184

Specialties & licenses 1

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

Addresses

Primary practice location

10030 Gilead Road
Huntersville, NC 28078

Mailing address

2085 Frontis Plaza Boulevard
Winston-Salem, NC 27103
Phone (336) 277-7226

Other identifiers 2

IdentifierTypeStateIssuer
2379000OtherNCMEDICARE PTAN
2839020OtherNCCIGNA PROVIDER NUMBER

Other names 1

  • Novant Health Huntersville Outpatient Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100521000450 NC Part B Supplier - Ambulatory Surgical Center 8426197971 Receives reassigned benefits from 538 practitioners
1 other NPI on this enrollment
Practice locations: Huntersville, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Novant Health Huntersville Outpatient Surgery CenterCCN 34C0001168
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Huntersville Outpatient Su2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10030 Gilead Rd
Ste 120
Huntersville, NC 28078
Phone (704) 316-5670

Practitioners & affiliated clinicians

Practitioners 538

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 538

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1063641801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BOULEVARD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 GILEAD ROAD",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "28078",
            "telephone_number": "704-316-4010",
            "fax_number": "704-316-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "HARGETT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-384-5184"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2379000",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "2839020",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Huntersville Outpatient Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.