NPIMap

Organization Active NPI

The Presbyterian Hospital

Doing business as Presbyterian ESRD Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
National Provider Identifier
1396798591
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
THE PRESBYTERIAN HOSPITAL
Doing business as
Presbyterian ESRD Unit
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4000
NPI assigned
May 18, 2006
Last updated
Nov 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Authorized official

Name
Mrs. Pamela Rollins Vincent
Title
Coo/President
Phone
(704) 384-9656

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X NC Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

2085 Frontis Plaza Blvd
Winston-Salem, NC 27103-5614
Phone (336) 277-7226

Other names 1

  • Presbyterian ESRD Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061218000496 NC Part A Provider - Hospital 1153231907 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396798591. Details of each certification follow.

Hospital certification: CCN 340053

Legal name
THE PRESBYTERIAN HOSPITAL
Doing business as
NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 4, 2011
Beds
877
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1903 in NC
Enrollment address
200 Hawthorne Lane
Charlotte, NC 28204-2515
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric unit, Specialty hospital, Other

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Novant Health Presbyterian Medical CenterCCN 340053 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James C Johnson Individual Corporate DirectorBot Jan 1, 2017
Kandi Deitemeyer Individual Corporate OfficerTrustee Jan 1, 2021
Carl S Armato Individual Corporate Director Jan 1, 2017
W-2 Managing EmployeePresident & Ceo Jan 1, 2012
Operational/Managerial ControlPresident & Ceo Jan 1, 2012
Kimberly a Case Individual Corporate DirectorBot Member May 1, 2021
Thaddeus Vontrell Jones Individual Corporate DirectorBoard Member Jan 1, 2018
John Morgan Lewis Individual Corporate DirectorTreasurer Jan 1, 2018
James Patrick Taylor Individual Corporate DirectorBoard Member Jan 1, 2019
Patrick a Wilson Individual Corporate Director May 1, 2023
Marsha Janelle Lyons Individual Corporate DirectorBoard Member Jan 1, 2018
Louis G Lobo Individual Corporate DirectorBot Jan 1, 2020
Novant Health, Inc. Organization, Winston Salem, NC Corporation 5% Or Greater Direct Ownership Interest Jan 1, 2007 100%
Jamie Feinour Individual Corporate OfficerPresident Nhpmc Mar 23, 2025
W-2 Managing Employee Mar 23, 2025
Saad Ehtisham Individual Corporate OfficerBot Pres Apr 9, 2019
Tera Black Individual Corporate DirectorBot Member Jan 1, 2025
Novant Health Southern Piedmont Region, LLC Organization, Winston Salem, NC Corporation Operational/Managerial Control Mar 22, 2014

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1,801

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,801

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1396798591",
    "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": "271035614",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ROLLINS",
        "authorized_official_title_or_position": "COO/PRESIDENT",
        "authorized_official_telephone_number": "704-384-9656",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian ESRD Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.