Active NPI
Signature Plastic & Reconstructive Surgery, PLLC
- Plastic Surgery Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- SIGNATURE PLASTIC & RECONSTRUCTIVE SURGERY, PLLC
- Practice address
- 13545 Steelecroft Pkwy Ste 110
Charlotte, NC 28278-7562 - Phone
- (352) 514-1524
- NPI assigned
- May 30, 2017
- Organization subpart
- Yes
- Parent organization
- -
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melissa Marks, D.O.
- Title
- Manager
- Phone
- (352) 514-1524
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | OS14397 | FL | |
| Plastic Surgery Physician | 208200000X | Primary |
Addresses
Primary practice location
13545 Steelecroft Pkwy Ste 110
Charlotte, NC 28278-7562
Mailing address
13545 Steelecroft Pkwy Ste 110
Charlotte, NC 28278-7562
Phone (352) 514-1524
Other practice location 1
3345 Burns Rd Ste 101
Palm Beach Gardens, FL 33410-4304
Phone (561) 775-1212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Signature Plastic Recon
Locations
13545 Steelecroft Pkwy
Ste 110
Charlotte, NC 28278
Phone (352) 514-1524
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- Charlotte, NC
- NPI 1518278175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667520000000",
"number": "1508394990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13545 STEELECROFT PKWY STE 110",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282787562",
"telephone_number": "352-514-1524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13545 STEELECROFT PKWY STE 110",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282787562",
"telephone_number": "352-514-1524"
}
],
"practiceLocations": [
{
"address_1": "3345 Burns Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Palm Beach Gardens",
"state": "FL",
"postal_code": "334104304",
"country_code": "US",
"telephone_number": "561-775-1212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SIGNATURE PLASTIC & RECONSTRUCTIVE SURGERY, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "-",
"enumeration_date": "2017-05-30",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A",
"authorized_official_last_name": "MARKS",
"authorized_official_first_name": "MELISSA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "352-514-1524",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "FL",
"license": "OS14397",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Nov 4, 2022; 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.