NPIMap

Organization Active NPI

Presbyterian Regional Healthcare Corp

Doing business as Ballantyne Medical Group

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1548223803
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRESBYTERIAN REGIONAL HEALTHCARE CORP
Doing business as
Ballantyne Medical Group
Practice address
15825 John J Delaney Dr
Suite 200
Charlotte, NC 28277-3146
Phone
(704) 384-1925
Fax
(704) 384-1930
NPI assigned
Apr 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Patrick D Easterling
Title
Sr. Vice President
Phone
(704) 384-9103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

15825 John J Delaney Dr
Suite 200
Charlotte, NC 28277-3146

Mailing address

1900 Randolph Rd
Suite 500
Charlotte, NC 28207-1106
Phone (704) 384-9103

Other identifiers 1

IdentifierTypeStateIssuer
89014VGMedicaidNC

Other names 1

  • Ballantyne Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Inpt Care503 organizations share this tax ID, including this one

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

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548223803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "SUITE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071106",
            "telephone_number": "704-384-9103",
            "fax_number": "704-316-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 JOHN J DELANEY DR",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773146",
            "telephone_number": "704-384-1925",
            "fax_number": "704-384-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN REGIONAL HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EASTERLING",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "704-384-9103",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014VG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballantyne Medical Group",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.