Nccrteam

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NCCRTEAM

Practice address

1911 Sugarbush Dr
Charlotte, NC 28214-1082

Phone

(704) 493-1641

NPI assigned

Aug 30, 2021

Organization subpart

No

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

Authorized official

Name

Natsha Johnson

Title

Executor

Phone

(704) 493-1641

Specialties & licenses 3

Addresses

Other names 1

• NCCRTEAM Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1427726157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 SUGARBUSH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282141082",
            "telephone_number": "704-493-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 SUGARBUSH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282141082",
            "telephone_number": "704-493-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCCRTEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NATSHA",
        "authorized_official_title_or_position": "EXECUTOR",
        "authorized_official_telephone_number": "704-493-1641"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1911 Sugarbush Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282141082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NCCRTEAM",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NCCRTEAM",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.