NPIMap

Individual provider Active NPI

Edgar O. Hartle, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Mooresville, NC
National Provider Identifier
1194789578
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
26934 Issued in NC
Practice address
171 Fairview Rd
Mooresville, NC 28117-9500
Phone
(704) 660-4512
Fax
(704) 660-4903
NPI assigned
Apr 13, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 26934 NC Primary

Addresses

Primary practice location

171 Fairview Rd
Mooresville, NC 28117-9500

Mailing address

PO Box 49009
Greenwood, SC 29649-0001
Phone (864) 223-3070

Other identifiers 3

IdentifierTypeStateIssuer
1227POtherNCBCBS
26934OtherNCNC MEDICAL LICENSE #
891227PMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000173 NC Practitioner - Pathology 3375644339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Perelman School of Med at the University of Pennsylvania, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

171 Fairview Rd
Mooresville, NC 28117-9500
Phone (704) 660-4511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26934NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L a Lorenzo MD Pathology Consult Services P a Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2003 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Nov 9, 2025 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Nov 9, 2025 Accepting new patients
Iredell Memorial Hospital, Incorporated Past Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

171 Fairview Rd
Mooresville, NC 28117
Phone (704) 660-4000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194789578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49009",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490001",
            "telephone_number": "864-223-3070",
            "fax_number": "864-223-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 FAIRVIEW RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179500",
            "telephone_number": "704-660-4512",
            "fax_number": "704-660-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLE",
        "first_name": "EDGAR",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "26934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1227P",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL LICENSE #",
            "identifier": "26934",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891227P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.