Eagle Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200501333 Issued in NC

Legal business name

EAGLE MEDICAL CENTER

Practice address

6005 Hickory Grove Road
Charlotte, NC 28215-5104

Phone

(704) 945-6480

Fax

(704) 926-5439

NPI assigned

Jul 12, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Lhynne Lesko

Title

Business Administrator

Phone

(704) 934-5434

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Eagle Medical Center

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1245563352

  O20091211000566

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Kathleen Elise Barber, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Charlotte, NC
  • NPI 1770067399
  NPD (past)
• Michelle Victoria- Dominique Harvey, PA-C

  • Physician Assistant
  • Gastonia, NC
  • NPI 1962160549
  NPD (past)

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1487942314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 HICKORY GROVE ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28215",
            "telephone_number": "704-945-6480",
            "fax_number": "704-926-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 HICKORY GROVE ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155104",
            "telephone_number": "704-945-6480",
            "fax_number": "704-926-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "LESKO",
        "authorized_official_first_name": "LHYNNE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "704-934-5434",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200501333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "14096",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913081",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eagle Africa Trading and Distribution Corporation
• Eagle Africa Trading and Distribution Corporation
• Eagle Care ABA
• Eagle Chiropractic Clinic
• Eagle Medical Center
• Eagle Rising Health Services, PLLC
• Eagle Therapeutic Services PLLC
• Eagles Will NC LLC
• Kathyrn Grace Eaker, MD
• Tracy Nicole Eakins, SLP

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.