Lake Norman Plastic Surgery, PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

LAKE NORMAN PLASTIC SURGERY, PLLC

Practice address

9735 Kincey Ave Ste 205
Huntersville, NC 28078-9120

Phone

(704) 885-0550

Fax

(704) 885-0550

NPI assigned

May 26, 2025

Organization subpart

No

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

Authorized official

Name

Henry Wilson, MDNPI 1558496117

Title

Physician Owner

Phone

(704) 885-0550

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henry B Wilson, MD

  • Plastic Surgery Physician
  • Huntersville, NC
  • NPI 1558496117
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1720871593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE STE 205",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789120",
            "telephone_number": "704-885-0550",
            "fax_number": "704-885-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE STE 205",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789120",
            "telephone_number": "704-885-0550",
            "fax_number": "704-885-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE NORMAN PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "704-885-0550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwilson@lknplasticsurgery.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange/HISP email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Secure Messaging (HISP)",
            "address_1": "9735 Kincey Ave Ste 205",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280789120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber A Lagrew, OT
• Thomas Lahart
• Lake Norman Community Health Clinic
• Lake Norman Mind and Body Connection PLLC
• Lake Norman Nutrition Associates, LLC
• Lake Norman Psychological Services PLLC
• Lake Norman Treatment Associates, LLC
• Josephine H Lake, MD
• Lakeshore Counseling and Coaching
• Lakeside Health & Rehab Center, LLC

• Plastic Surgery Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.