NPIMap

Organization Active NPI

Charlotte Neuroscience Foundation

Doing business as Memory & Movement Charlotte

  • Neurology Physician
  • Charlotte, NC
National Provider Identifier
1508394750
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
CHARLOTTE NEUROSCIENCE FOUNDATION
Doing business as
Memory & Movement Charlotte
Practice address
411 Billingsley Rd Ste 103
Charlotte, NC 28211-1066
Phone
(704) 577-3186
Fax
(704) 626-2701
NPI assigned
Jun 1, 2017
Last updated
Jan 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Sanjay S IyerNPI 1376561472
Title
Medical Director
Phone
(704) 577-3186

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

411 Billingsley Rd Ste 103
Charlotte, NC 28211-1066

Mailing address

411 Billingsley Rd Ste 103
Charlotte, NC 28211-1066
Phone (704) 577-3186

Other names 1

  • Memory & Movement Charlotte Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170615000272 NC Part B Supplier - Clinic/Group Practice 7214205277 Receives reassigned benefits from 14 practitioners
Practice locations: Charlotte, NC; Fort Mill, SC

National Provider Directory

National Provider Directory

Locations

300 Billingsley Rd
Ste 108
Charlotte, NC 28211
Phone (704) 577-3186

8919 Park Rd
Fl 3
Charlotte, NC 28210
Phone (704) 577-3186

1061 Gold Hill Rd
Fort Mill, SC 29708
Phone (803) 548-3825

5028 Holloway Dr
Fort Mill, SC 29715
Phone (704) 285-8207

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1508394750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111066",
            "telephone_number": "704-577-3186",
            "fax_number": "704-626-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111066",
            "telephone_number": "704-577-3186",
            "fax_number": "704-626-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE NEUROSCIENCE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-01",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "IYER",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-577-3186"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memory & Movement Charlotte",
            "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 Jan 9, 2024; 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.