Charlotte Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CHARLOTTE SURGERY CENTER, LLC

Practice address

3621 Randolph Rd Ste 200
Charlotte, NC 28211-0027

Phone

(704) 377-1647

NPI assigned

Oct 16, 2018

Organization subpart

Yes

Parent organization

CHARLOTTE SURGERY CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Thomas James Lally

Title

Chief Administrative Officer

Phone

(704) 377-1647

Specialties & licenses 1

Addresses

Other names 1

• Charlotte Surgery Center-Wendover Campus Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1891750998

  8820196538

  Same PAC ID

Listed as

Charlotte Surgery CenterCCN 34C0001207

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

Healthsouth Surgery Cen2 organizations share this tax ID, including this one

Part of

Healthsouth Surgery Cen

Other organizations with this tax ID 1

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

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1891750998
  NPD tax ID

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Orthocarolina, PA

  • Physician Assistant
  • Jefferson, NC
  • NPI 1619217551

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866

  Member Of

  NPD member

Locations

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.

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1891750998
  NPPES parent name

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1124594338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 RANDOLPH RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110027",
            "telephone_number": "704-377-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 RANDOLPH RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110027",
            "telephone_number": "704-377-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE SURGERY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLOTTE SURGERY CENTER, LLC",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "704-377-1647"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte Surgery Center-Wendover Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charlotte SP Senior Housing Opco, LLC
• Charlotte Speech and Hearing Center
• Charlotte Speech and Hearing Center, Inc.
• Charlotte Sports Medicine Institute, P.a.
• Charlotte Sports Performance and Rehab, LLC
• Charlotte Surgery Center, LLC
• Charlotte Therapy Associates
• Charlotte Transportation Inc
• Charlotte Trauma Services, PLLC
• Charlotte True Health Chiropractic, PLLC

• Ambulatory Surgical Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.