Tryon Endoscopy Center, LLC
Organization Active NPI Endoscopy Clinic/Center · Charlotte, NC
NPI 1700359403 · NPPES record last updated Mar 14, 2024
Key facts
- NPI
- 1700359403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Endoscopy Clinic/Center 261QE0800X
- Legal business name
- TRYON ENDOSCOPY CENTER, LLC
- Practice address
- 16817 Marvin Road
Charlotte, NC 28277-2196 - Phone
- (704) 495-6036
- NPI assigned
- Jan 4, 2019
- Organization subpart
- No
Authorized official
- Name
- Malikah Y Hodo
- Title
- Revenue Cycle Manager
- Phone
- (704) 259-4621
Practitioners 1
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Tryon Endoscopy Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2159166 | Tryon Endoscopy Center | Certificate of waiver | Dec 12, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190726001777 | NC | Part B Supplier - Ambulatory Surgical Center | 1456687532 | Practice locations: Charlotte, NC |
National Provider Directory
Locations
16817 Marvin Rd
Charlotte, NC 28277
Phone (704) 275-3256
Interoperability endpoints
- https://api.platform.athenahealth.com/17847/brand/1/csg/41/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | |||
| Endoscopy Clinic/Center | 261QE0800X | Yes |
Addresses
Primary practice location
16817 Marvin Road
Charlotte, NC 28277-2196
Mailing address
5960 Fairview Rd Ste 500
Charlotte, NC 28210-3113
Phone (704) 495-6334
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- James M Tsahakis
All providers in Charlotte, NC · Endoscopy Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.