NPIMap

Organization Active NPI

Charlotte Gastroenterology & Hepatology, PLLC

  • Gastroenterology Physician
  • Huntersville, NC
National Provider Identifier
1730100801
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC
Practice address
13808 Professional Center Dr
Huntersville, NC 28078-7948
Phone
(704) 377-4009
NPI assigned
Jul 22, 2006
Last updated
May 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Authorized official

Name
Mrs. Jennifer Hicks
Title
Ceo
Phone
(704) 377-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

13808 Professional Center Dr
Huntersville, NC 28078-7948

Mailing address

2015 Randolph Rd
Suite 208
Charlotte, NC 28207-1128
Phone (704) 377-4009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223000424 NC Part B Supplier - Clinic/Group Practice 3870489412 Receives reassigned benefits from 97 practitioners
Practice locations: Charlotte, NC; Huntersville, NC; Matthews, NC; Mooresville, NC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

4425 Randolph Rd
Ste 105
Charlotte, NC 28211

1340 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 708-9185

Practitioners & affiliated clinicians

Practitioners 103

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 103

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1730100801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD",
            "address_2": "SUITE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071128",
            "telephone_number": "704-377-4009",
            "fax_number": "704-815-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13808 PROFESSIONAL CENTER DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787948",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-377-4009",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.