NPIMap

Organization Active NPI

The Presbyterian Hospital

Doing business as Novant Health Presbyterian Medical Center CRNAs

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1487626933
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
THE PRESBYTERIAN HOSPITAL
Doing business as
Novant Health Presbyterian Medical Center CRNAs
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4239
Fax
(704) 384-5636
NPI assigned
Feb 7, 2006
Last updated
Jul 30, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
THE PRESBYTERIAN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Amy S. Vance
Title
Coo
Phone
(704) 384-4559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

PO Box 601549
Charlotte, NC 28260-1549
Phone (704) 384-4239

Other identifiers 2

IdentifierTypeStateIssuer
NPA843MedicaidSC
8000218MedicaidNC

Other names 1

  • Novant Health Presbyterian Medical Center CRNAs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000588 NC Part B Supplier - Clinic/Group Practice 1153231907 Receives reassigned benefits from 77 practitioners
3 other NPIs on this enrollment
Practice locations: Charlotte, NC; Huntersville, NC

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Hosp Sup51 organizations share this tax ID, including this one
Part of
Presbyterian Hosp Sup

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 257

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 257

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1487626933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601549",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601549",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        },
        {
            "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": "704-384-4239",
            "fax_number": "704-384-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PRESBYTERIAN HOSPITAL",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "704-384-4559"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPA843",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000218",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Presbyterian Medical Center CRNAs",
            "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 30, 2013; 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.