Carolina Endovascular and Interventional PLLC

Key facts

NPI: 1487531059
Entity type: Organization (NPI type 2)
Primary specialty: Vascular & Interventional Radiology Physician 2085R0204X
Legal business name: CAROLINA ENDOVASCULAR AND INTERVENTIONAL PLLC
Practice address: 6060 Piedmont Row Dr S Ste 200
Charlotte, NC 28287-3888
Phone: (704) 705-8602
Fax: (877) 531-1009
NPI assigned: Aug 18, 2025
Organization subpart: No

Authorized official

Name: Peter O Simon Jr., MD NPI 1982644928
Title: Member/Organizer
Phone: (704) 705-8602

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Peter Otto Simon Jr., MD Vascular & Interventional Radiology Physician · Charlotte, NC · NPI 1982644928

Medicare reassignment Care Compare group NPD Authorized official DIAGNOSTIC RADIOLOGY · NC
Dylan Joseph Suttle, M.D. Vascular & Interventional Radiology Physician · Greensboro, NC · NPI 1942695382

Medicare reassignment Care Compare group NPD DIAGNOSTIC RADIOLOGY · NC
Heath Keay McCullough, MD Vascular & Interventional Radiology Physician · High Point, NC · NPI 1366641243

Medicare reassignment NPD DIAGNOSTIC RADIOLOGY · NC

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20251126002717	NC	Part B Supplier - Clinic/Group Practice	0840782777	Receives reassigned benefits from 3 practitioners Practice locations: Charlotte, NC; Greensboro, NC

National Provider Directory

Locations

6060 Piedmont Row Dr S
Ste 200
Charlotte, NC 28287
Phone (704) 705-8602

1305 Lees Chapel Rd
Greensboro, NC 27455
Phone (336) 967-7501

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Diagnostic Radiology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2085R0202X
Vascular & Interventional Radiology Physician Group: 193200000X MULTI-SPECIALTY GROUP	2085R0204X			Yes

Addresses

Primary practice location

6060 Piedmont Row Dr S Ste 200
Charlotte, NC 28287-3888

Mailing address

6060 Piedmont Row Dr S Ste 200
Charlotte, NC 28287-3888
Phone (704) 705-8602

Other providers in Charlotte, NC

All providers in Charlotte, NC · Vascular & Interventional Radiology Physician in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.