Waveco LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AS0058 Issued in NC

Legal business name

WAVECO LLC

Practice address

1822 Brunswick Ave
Charlotte, NC 28207-1820

Phone

(704) 831-4400

Fax

(704) 831-4401

NPI assigned

Jun 22, 2006

Organization subpart

No

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

Authorized official

Name

Troy Bouzakis

Title

Ceo

Phone

(704) 376-1605

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolina Center for Specialty Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Hospital certification: CCN 340193

Legal name

CAROLINA CENTER FOR SPECIALTY SURGERY

Certification status

Terminated Voluntary: merger or closure, Jul 1, 2021

Provider type (POS)

Hospital – Short-term

Participating since

Sep 10, 2020

Last certification

Sep 10, 2020

Beds

1

Ownership / control type

Private (for profit)

Facility address

1822 Brunswick Ave
Charlotte, NC 28207

Listed as

Carolina Center for Specialty SurgeryCCN 34C0001108

Medicare certification status

ActiveFrom the Provider of Services file

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• The Charlotte-Mecklenburg Hospital Authority

  • Orthopaedic Surgery Physician
  • Denver, NC
  • NPI 1477884302

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866

  Member Of

  NPD member
• Carolina Neurosurgery & Spine Associates PA

  • Neurological Surgery Physician
  • Rock Hill, SC
  • NPI 1548819170

  Member Of

  NPD member

Member organizations 1

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

• Perioperative Services, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1023323128

  Member Of

  NPD member

Practitioners 1

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

• Emmet Hunter Dyer, MD

  • Neurological Surgery Physician
  • Charlotte, NC
  • NPI 1962400903
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1760418917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 BRUNSWICK AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071820",
            "telephone_number": "704-831-4400",
            "fax_number": "704-831-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 BRUNSWICK AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071820",
            "telephone_number": "704-831-4400",
            "fax_number": "704-831-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVECO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "BOUZAKIS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-376-1605"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760418917",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Center for Specialty Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larry T. Watts, MD
• Latasha Denise Watts, LCSW
• Logan Elizabeth Watts, FNP-C
• Meta Felice Watts, COTA/L
• Teressa McKoy Watts, MD
• Waverly Surgery Center, PA
• Dael Waxman, MD
• Brooke Mary Way
• Lauren Elaine Kenley Wayenberg, LCSWA
• Marcia Sue Waymouth, CCC-A

• Ambulatory Surgical Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.