Endoscopy Center -Pineville LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENDOSCOPY CENTER -PINEVILLE LLC

Doing business as

Carolina Endoscopy Center -Pineville

Practice address

10520 Park Rd
Suite 105
Charlotte, NC 28210-8487

Phone

(704) 927-5756

Fax

(704) 927-5757

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Julie Rothrock

Title

Credentialing Coordinator

Phone

(704) 372-7974

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolina Endoscopy Center -Pineville Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Carolina Endoscopy Center PinevilleCCN 34C0001132

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Carolina Digestive Health Associates, PA

  • Gastroenterology Physician
  • Charlotte, NC
  • NPI 1124052444

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Primary Care Cabarrus Family Medicine Midland

  • Family Medicine Physician
  • Midland, NC
  • NPI 1265869846

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ronnie Cyzner, M.D.

  • Gastroenterology Physician
  • Charlotte, NC
  • NPI 1528086980
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1205908456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 TORINGDON WAY STE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773497",
            "telephone_number": "704-372-7974",
            "fax_number": "704-970-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 PARK RD",
            "address_2": "SUITE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108487",
            "telephone_number": "704-927-5756",
            "fax_number": "704-927-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER -PINEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "ROTHROCK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "704-372-7974"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, OTHER",
            "identifier": "2381097A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Endoscopy Center -Pineville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Endoscopy Center -Pineville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.