Individual provider Active NPI

Ervin Sherwood Batchelor Jr., PH.D.

  • Clinical Neuropsychologist
  • Charlotte, NC
National Provider Identifier
1235118654
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1659 Issued in NC
Practice address
1718 E 4TH St
Suite 702
Charlotte, NC 28204-3260
Phone
(704) 372-5997
Fax
(704) 372-2330
NPI assigned
Jan 13, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1659 NC Primary

Addresses

Primary practice location

1718 E 4TH St
Suite 702
Charlotte, NC 28204-3260

Mailing address

1718 E 4TH St
Suite 702
Charlotte, NC 28204-3260
Phone (704) 372-5997

Other identifiers 1

IdentifierTypeStateIssuer
6000052MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1659NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Neil Group, Inc CurrentSince Jun 1, 2022 Accepting new patients
Ervin S. Batchelor, PA Clinical Neuropsychologist PastSince Nov 30, 2007 Accepting new patients

Locations

1399 Ashleybrook Ln
Ste 100
Winston Salem, NC 27103
Phone (336) 446-9080

Organizations & group practices 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1235118654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-372-5997",
            "fax_number": "704-372-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 702",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043260",
            "telephone_number": "704-372-5997",
            "fax_number": "704-372-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATCHELOR",
        "first_name": "ERVIN",
        "middle_name": "SHERWOOD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "1659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000052",
            "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 Dec 6, 2007; 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.