NPIMap

Organization Active NPI

Carolinas Medical Center

Doing business as Levine Children's Specialty Center - Ballantyne

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1083905079
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CAROLINAS MEDICAL CENTER
Doing business as
Levine Children's Specialty Center - Ballantyne
Practice address
14214 Ballantyne Lake Rd
Suite 150
Charlotte, NC 28277-3372
Phone
(704) 667-2680
NPI assigned
Apr 25, 2011
Last updated
Apr 25, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Mr. Dennie Underwood
Title
Vice President
Phone
(704) 355-3147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

14214 Ballantyne Lake Rd
Suite 150
Charlotte, NC 28277-3372

Mailing address

PO Box 601372
Charlotte, NC 28260-1372

Other names 1

  • Levine Children's Specialty Center - Ballantyne Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Mecical Ctr N69 organizations share this tax ID, including this one
Part of
Carolinas Mecical Ctr N

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1083905079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601372",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14214 BALLANTYNE LAKE RD",
            "address_2": "SUITE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372",
            "telephone_number": "704-667-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "DENNIE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-3147",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Levine Children's Specialty Center - Ballantyne",
            "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 Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.