Individual provider Active NPI

Samuel C Sayson, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1356336796
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
200000131 Issued in NC
Practice address
200 Providence Rd
Suite 101
Charlotte, NC 28207-1468
Phone
(704) 749-5800
Fax
(704) 749-5819
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 200000131 NC Primary

Addresses

Primary practice location

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468

Mailing address

200 Providence Rd
Suite 101
Charlotte, NC 28207-1468
Phone (704) 749-5800

Other identifiers 1

IdentifierTypeStateIssuer
891251XMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100917000761 NC Practitioner - Anesthesiology 5597880252 Reassigns benefits to 1 organization
I20180410002693 SC Practitioner - Anesthesiology 5597880252 Reassigns benefits to 1 organization
I20231016001360 CA Practitioner - Anesthesiology 5597880252 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200000131NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Jan 22, 2000 Accepting new patients
Sacsolano Anesthesia Exchange Medical Group, Inc Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
Ambulatory Anesthesia of Pinehurst, PA Anesthesiology Past Accepting new patients

Locations

3315 Watt Ave
Sacramento, CA 95821
Phone (916) 481-0777

200 Providence Rd
Ste 101
Charlotte, NC 28207

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

3735 Glenlake Dr
Ste 250
Charlotte, NC 28208
Phone (704) 749-5801

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1356336796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROVIDENCE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071468",
            "telephone_number": "704-749-5800",
            "fax_number": "704-749-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYSON",
        "first_name": "SAMUEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "200000131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891251X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.