NPIMap

Organization Active NPI

The Presbyterian Hospital

Doing business as Novant Health Heart and Vascular Institute

  • Cardiovascular Disease Physician
  • Charlotte, NC
National Provider Identifier
1457695264
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
THE PRESBYTERIAN HOSPITAL
Doing business as
Novant Health Heart and Vascular Institute
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3215
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Nov 16, 2012
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

1718 E 4th St Ste 604
Charlotte, NC 28204-3196
Phone (704) 343-4424

Other practice location 2

1718 E 4th St
Suite 501
Charlotte, NC 28204-3197
Phone (704) 343-9800

Other names 1

  • Novant Health Heart and Vascular Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223001121 NC Part B Supplier - Clinic/Group Practice 1153231907 Receives reassigned benefits from 988 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC; Cornelius, NC; Huntersville, NC; Matthews, NC; Monroe, NC; Mooresville, NC

Other NPIs on the same Medicare enrollment 34

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

View all 34

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1457695264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E 4th St Ste 604",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043196",
            "country_code": "US",
            "telephone_number": "704-343-4424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 E 4th St",
            "address_2": "Suite 501",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043197",
            "country_code": "US",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Heart and Vascular Institute",
            "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 Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.