NPIMap

Carolina Digestive Health Associates, PA

Organization Active NPI Gastroenterology Physician · Charlotte, NC

NPI 1124052444 · NPPES record last updated Sep 17, 2024

Key facts

NPI
1124052444
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA
Practice address
300 Billingsley Rd Ste 200
Charlotte, NC 28211-1180
Phone
(704) 372-7974
Fax
(704) 372-8201
NPI assigned
Jul 11, 2006
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 1

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 77

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

View all 77

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031230000650 NC Part B Supplier - Clinic/Group Practice 1951209790 Receives reassigned benefits from 72 practitioners
Practice locations: Concord, NC; Monroe, NC; Matthews, NC; Denver, NC; Davidson, NC; Charlotte, NC; Belmont, NC
O20230525000730 NC Part B Supplier - Independent Clinical Laboratory 1951209790 Practice locations: Charlotte, NC

National Provider Directory

Locations

1105 Spruce St
Belmont, NC 28012

3426 Toringdon Way
Ste 108
Charlotte, NC 28277

8210 University Exec Park Dr
Ste 100
Charlotte, NC 28262
Phone (704) 547-8818

8210 University Exec Park Dr
Ste 110
Charlotte, NC 28262
Phone (704) 549-1181

8220 University Exec Park Dr
Ste 100
Charlotte, NC 28262

101 E W T Harris Blvd
#32
Charlotte, NC 28262

300 Billingsley Rd
Ste 200A
Charlotte, NC 28211

300 Billingsley Rd
#200A
Charlotte, NC 28211

10620 Park Rd
Ste 212
Charlotte, NC 28210

300 Billingsley Rd
#200B
Charlotte, NC 28211

8210 University Exec Park Dr
Charlotte, NC 28262

300 Billingsley Rd
Ste 300
Charlotte, NC 28211

101 E Wt Harris Blvd
Ste 3111
Charlotte, NC 28262
Phone (704) 547-0834

300 Billingsley Rd
Ste 103
Charlotte, NC 28211
Phone (704) 372-1306

10620 Park Rd
#212
Charlotte, NC 28210
Phone (704) 543-7305

246 Le Phillip Ct NE
Concord, NC 28025

1085 NE Gateway Ct NE
Ste 280
Concord, NC 28025
Phone (704) 455-9700

4315 Physicians Blvd
Ste 202
Harrisburg, NC 28075
Phone (704) 455-9700

16455 Statesville Rd
Ste 114
Huntersville, NC 28078
Phone (704) 237-9290

16633 Birkdale Commons Pkwy
#150
Huntersville, NC 28078
Phone (704) 405-0723

1450 Matthews Township Pkwy
Ste 460
Matthews, NC 28105
Phone (704) 814-1799

1663 Campus Park Dr
Ste D
Monroe, NC 28112
Phone (704) 291-2488

131 Medical Park Rd
Ste 307
Mooresville, NC 28117
Phone (704) 799-2750

547 Highland St
Mt Holly, NC 28120
Phone (704) 820-9430

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0100X 40474 NC
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0100X Yes

Addresses

Primary practice location

300 Billingsley Rd Ste 200
Charlotte, NC 28211-1180

Mailing address

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

Other practice location 1

300 Billingsley Rd Ste 103
Charlotte, NC 28211-1084
Phone (704) 372-7974

Other identifiers

IdentifierTypeStateIssuer
7901569MedicaidNC

Other names

  • Carolina Digestive Pathology Lab Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 17, 2024.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1124052444",
    "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": "704-372-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BILLINGSLEY RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111180",
            "telephone_number": "704-372-7974",
            "fax_number": "704-372-8201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Billingsley Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111084",
            "country_code": "US",
            "telephone_number": "704-372-7974",
            "fax_number": "704-372-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "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": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "40474",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901569",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Digestive Pathology Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

All providers in Charlotte, NC · Gastroenterology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.