NPIMap

Organization Active NPI

Presbyterian Breast Center, LLC

Doing business as Presbyterian Breast Center University

  • Mammography Clinic/Center
  • Charlotte, NC
National Provider Identifier
1558312413
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
PRESBYTERIAN BREAST CENTER, LLC
Doing business as
Presbyterian Breast Center University
Practice address
8401 Medical Plaza Dr
Charlotte, NC 28262-8797
Phone
(704) 384-7140
NPI assigned
May 15, 2006
Last updated
Nov 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Fred M Hargett
Title
Evp Cfo
Phone
(704) 384-5184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X NU Primary

Addresses

Primary practice location

8401 Medical Plaza Dr
Charlotte, NC 28262-8797

Mailing address

2085 Frontis Plaza Blvd
Winston-Salem, NC 27103-5614
Phone (336) 277-7226

Other identifiers 2

IdentifierTypeStateIssuer
16-02145OtherUHC
89016K8MedicaidNC

Other names 1

  • Presbyterian Breast Center University Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Breast Center LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8401 Medical Plaza Dr
Charlotte, NC 28262
Phone (704) 208-4458

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1558312413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "336-277-7226",
            "fax_number": "336-277-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628797",
            "telephone_number": "704-384-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN BREAST CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "HARGETT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EVP CFO",
        "authorized_official_telephone_number": "704-384-5184"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "16-02145",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016K8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presbyterian Breast Center University",
            "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 Nov 11, 2010; 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.