Individual provider Active NPI

Charles Dana Hershey, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1558359083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
20606 Issued in NC
Practice address
1000 Blythe Blvd
Southeast Anesthesiology Consultants PA
Charlotte, NC 28203-5812
Phone
(704) 355-2372
Fax
(704) 355-6692
NPI assigned
Oct 10, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20606 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Southeast Anesthesiology Consultants PA
Charlotte, NC 28203-5812

Mailing address

PO Box 36351
Southeast Anesthesiology Consultants PA
Charlotte, NC 28236-6351
Phone (704) 377-5772

Other identifiers 2

IdentifierTypeStateIssuer
8941994MedicaidNC
208158OtherSCMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558359083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36351",
            "address_2": "SOUTHEAST ANESTHESIOLOGY CONSULTANTS PA",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282366351",
            "telephone_number": "704-377-5772",
            "fax_number": "704-377-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "address_2": "SOUTHEAST ANESTHESIOLOGY CONSULTANTS PA",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2372",
            "fax_number": "704-355-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHEY",
        "first_name": "CHARLES",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "20606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8941994",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "208158",
            "state": "SC"
        }
    ],
    "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 Jul 8, 2007; 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.