NPIMap

Organization Active NPI

University Womens Center PA

  • Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1184728453
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
UNIVERSITY WOMENS CENTER PA
Practice address
8220 University Exec Park Dr
Ste 107
Charlotte, NC 28262-3380
Phone
(704) 548-1221
Fax
(704) 548-1311
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Alexander Steven Petok
Title
Administrator
Phone
(704) 548-1221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X NC Primary

Addresses

Primary practice location

8220 University Exec Park Dr
Ste 107
Charlotte, NC 28262-3380

Mailing address

8220 University Exec Park Dr
Ste 107
Charlotte, NC 28262-3380
Phone (704) 548-1221

Other identifiers 1

IdentifierTypeStateIssuer
7902033MedicaidNC

National Provider Directory

National Provider Directory

Locations

8220 University Exec Park Dr
Ste 107
Charlotte, NC 28262
Phone (704) 548-1221

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1184728453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 UNIVERSITY EXEC PARK DR",
            "address_2": "STE 107",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623380",
            "telephone_number": "704-548-1221",
            "fax_number": "704-548-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 UNIVERSITY EXEC PARK DR",
            "address_2": "STE 107",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623380",
            "telephone_number": "704-548-1221",
            "fax_number": "704-548-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY WOMENS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETOK",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-548-1221",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.