Ballantyne Emergency Physicians PLLC
Organization Active NPI Emergency Medicine Physician · Charlotte, NC
NPI 1164052726 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1164052726
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- BALLANTYNE EMERGENCY PHYSICIANS PLLC
- Practice address
- 11516 Providence Rd
Charlotte, NC 28277-2691 - Phone
- (704) 667-0370
- NPI assigned
- Jan 23, 2020
- Organization subpart
- No
Authorized official
- Name
- Kim H Larsen
- Title
- Director of Credentialing
- Phone
- (770) 874-5400
Other NPIs on the same Medicare enrollment 1
Practitioners 153
-
Natacha Lauren Augustin, M.D.
-
Arin Piramzadian, D.O.
-
Iman Abdallah Tamimi, M.D.
-
Donovan Thompson, MD
-
Lauren Nicole Weiss, ACNP, FNP
-
Neal David Andrews, M.D.
-
Stephen Jackson, M.D.
-
Poonam Patel, M.D.
-
John C Wlezniak, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200513000736 | NC | Part B Supplier - Clinic/Group Practice | 8123459898 |
Receives reassigned benefits from 151 practitioners 1 other NPI on this enrollment Practice locations: Charlotte, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
11516 Providence Rd
Charlotte, NC 28277-2691
Mailing address
5665 New Northside Dr Ste 320
Atlanta, GA 30328-5834
Phone (770) 874-5400
Other providers in Charlotte, NC
- Tracy Brandon Ball
- Ballantyne Advanced Chiropractic PLLC
- Ballantyne Center for Dentistry
- Ballantyne Chiropractic
- Ballantyne Chiropractic Wellness
- Ballantyne Emergency Physicians PLLC
- Ballantyne Family Medicine PC
- Ballantyne Medical Associates PLLC
- Ballantyne Medical Associates PLLC
- Ballantyne Pharmacy LLC
All providers in Charlotte, NC · Emergency Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.