Individual provider Active NPI

James Witten Altizer, MD, FACPH

  • Specialist
  • Charlotte, NC
National Provider Identifier
1194866095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9900407 Issued in NC
Practice address
10502 Park Rd
Suite 120
Charlotte, NC 28210-8479
Phone
(704) 341-1122
Fax
(704) 341-2085
NPI assigned
Feb 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9900407 NC Primary

Addresses

Primary practice location

10502 Park Rd
Suite 120
Charlotte, NC 28210-8479

Mailing address

10502 Park Rd
Suite 120
Charlotte, NC 28210-8479
Phone (704) 341-1122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000047 NC Practitioner - Internal MedicinePractitioner - Peripheral Vascular DiseasePractitioner - Vascular Surgery 7416992938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Vascular Surgery
Education
Virginia Commonwealth University, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16147 Lancaster Hwy
Suite 140
Charlotte, NC 28277-4782
Phone (704) 727-6551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9900407NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Neogenix, PC CurrentSince Jan 1, 2020 Accepting new patients
Vein Associates Durham, P.C. Specialist Past Accepting new patients
Carolina Vein Center PLLC Past Accepting new patients

Locations

16147 Lancaster Hwy
Ste 140
Charlotte, NC 28277
Phone (704) 208-4134

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194866095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 PARK RD",
            "address_2": "SUITE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108479",
            "telephone_number": "704-341-1122",
            "fax_number": "704-341-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 PARK RD",
            "address_2": "SUITE 120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108479",
            "telephone_number": "704-341-1122",
            "fax_number": "704-341-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIZER",
        "first_name": "JAMES",
        "middle_name": "WITTEN",
        "name_prefix": "Dr.",
        "credential": "MD, FACPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9900407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.