Individual provider Active NPI

Marcia Haddock, CRNA

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1538126792
Registry record updated Aug 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
038766 Issued in NC
Practice address
200 Hawthorne Lane
Charlotte, NC 28204
Phone
(704) 384-4239
Fax
(704) 384-5636
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 038766 NC Primary

Addresses

Primary practice location

200 Hawthorne Lane
Charlotte, NC 28204

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
NAN427MedicaidSC
8050221MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031209000851 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5193621324 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Anesthesia Associates PAGroup PAC ID 1456251057, 67 clinicians
Carolina Regional Anesthesia PLLCGroup PAC ID 5496921769, 51 clinicians

Practice addresses (Care Compare)

458 13TH Ave NE
Hickory, NC 28601-2658
Phone (828) 328-1493

508 Morven Rd
Wadesboro, NC 28170-2745
Phone (704) 694-6902

5115 Oleander Dr
Wilmington, NC 28403-7018
Phone (910) 362-1011

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038766NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Apr 11, 2022 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Oct 1, 2012 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Apr 15, 2012 Accepting new patients
The Presbyterian Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Mooresville Hospital Management Associates, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Mooresville Hospital Management Associates LLC Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

200 Hawthorne Ln
Fl 2
Charlotte, NC 28204
Phone (704) 384-4274

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

2041 Valleygate Dr
Fayetteville, NC 28304
Phone (910) 323-5203

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

115 Commerce Pointe Blvd
Mooresville, NC 28117
Phone (423) 343-7032

508 Morven Rd
Wadesboro, NC 28170
Phone (704) 694-6902

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187481600000",
    "number": "1538126792",
    "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 LANE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-384-4239",
            "fax_number": "704-384-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "MARCIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2007-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "038766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN427",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050221",
            "state": "NC"
        }
    ],
    "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 Aug 19, 2007; 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.