NPIMap

Organization Active NPI

Presbyterian Sameday Surgery Center at Ballantyne LLC

Doing business as Novant Health Ballantyne Outpatient Surgery

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
National Provider Identifier
1215061049
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PRESBYTERIAN SAMEDAY SURGERY CENTER AT BALLANTYNE LLC
Doing business as
Novant Health Ballantyne Outpatient Surgery
Practice address
14215 Ballantyne Corporate PL Ste 210
Charlotte, NC 28277-3873
Phone
(704) 316-2650
Fax
(704) 316-2653
NPI assigned
Mar 15, 2007
Last updated
Oct 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Authorized official

Name
Fred M. Hargett
Title
Evp Cfo
Phone
(704) 384-5184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

14215 Ballantyne Corporate PL Ste 210
Charlotte, NC 28277-3873

Mailing address

2085 Frontis Plaza Blvd
Winston-Salem, NC 27103
Phone (336) 277-1065

Other names 1

  • Novant Health Ballantyne Outpatient Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070928000739 NC Part B Supplier - Ambulatory Surgical Center 4587759949 Receives reassigned benefits from 536 practitioners
1 other NPI on this enrollment
Practice locations: Charlotte, NC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Novant Health Ballantyne Outpatient SurgeryCCN 34C0001154
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Novant Health Ballantyne Outpatient Surg2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 537

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.

View all 537

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1215061049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-277-1065",
            "fax_number": "336-277-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14215 BALLANTYNE CORPORATE PL STE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773873",
            "telephone_number": "704-316-2650",
            "fax_number": "704-316-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN SAMEDAY SURGERY CENTER AT BALLANTYNE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "HARGETT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EVP CFO",
        "authorized_official_telephone_number": "704-384-5184"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Ballantyne Outpatient Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Novant Health Ballantyne Outpatient Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 4, 2018; 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.