NPIMap

Organization Active NPI

Novant Health Mint Hill Medical Center, LLC

Doing business as Professional Fees

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1063910404
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
NOVANT HEALTH MINT HILL MEDICAL CENTER, LLC
Doing business as
Professional Fees
Practice address
8201 Healthcare Loop
Charlotte, NC 28215-7072
Phone
(980) 302-1000
Fax
(980) 302-1001
NPI assigned
Jan 31, 2018
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Allison Joy Greear
Title
Pres & Coo
Phone
(704) 384-4089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

8201 Healthcare Loop
Charlotte, NC 28215-7072

Mailing address

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (336) 277-7226

Other names 1

  • PROFESSIONAL FEES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181018000540 NC Part B Supplier - Clinic/Group Practice 8123374394 Receives reassigned benefits from 700 practitioners
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).

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Mint Hill Medical Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

8201 Healthcare Loop
Ste 203
Charlotte, NC 28215
Phone (980) 302-2200

8201 Healthcare Loop
Ste 301
Charlotte, NC 28215
Phone (980) 302-3000

Practitioners & affiliated clinicians

Practitioners 702

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 702

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1063910404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "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": "8201 HEALTHCARE LOOP",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157072",
            "telephone_number": "980-302-1000",
            "fax_number": "980-302-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT HEALTH MINT HILL MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "GREEAR",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "PRES & COO",
        "authorized_official_telephone_number": "704-384-4089"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL FEES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROFESSIONAL FEES",
            "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 Feb 5, 2020; 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.