NPIMap

Organization Active NPI

Charlotte Eye Ear Nose & Throat Associates, PA

  • Otolaryngology Physician
  • Concord, NC
National Provider Identifier
1174814438
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Practice address
1085 NE Gateway CT NE
Suite 100
Concord, NC 28025-2406
Phone
(704) 782-2166
Fax
(704) 782-2533
NPI assigned
Apr 21, 2011
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Jag S Gill, SCD
Title
Ceo/Administrator
Phone
(704) 295-3366

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary
Audiologist 231H00000X
Audiologist-Hearing Aid Fitter 237600000X
Hearing Instrument Specialist 237700000X

Addresses

Primary practice location

1085 NE Gateway CT NE
Suite 100
Concord, NC 28025-2406

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

National Provider Directory

National Provider Directory
Tax ID family
Charlotte Eye Ear Nose an19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

1085 NE Gateway Ct NE
Ste 100
Concord, NC 28025
Phone (704) 707-2200

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1174814438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 NE GATEWAY CT NE",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252406",
            "telephone_number": "704-782-2166",
            "fax_number": "704-782-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "JAG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "704-295-3366",
        "authorized_official_credential": "SCD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.