Head Injury Center of Charlotte, Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

HEAD INJURY CENTER OF CHARLOTTE, INC.

Doing business as

Carolina NeuroServices

Practice address

6853 Fairview Rd
Suite B
Charlotte, NC 28210-3363

Phone

(704) 366-9930

NPI assigned

Jul 22, 2005

Last updated

Sep 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Peter Jeffrey Ewert, PH. D.NPI 1730188020

Title

President

Phone

(704) 366-9930

Specialties & licenses 1

Addresses

Other names 1

• Carolina NeuroServices Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 6

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.

• Peter Jeffrey Ewert, PHD

  • Clinical Neuropsychologist
  • Charlotte, NC
  • NPI 1730188020
  Medicare reassignment NPD Authorized official
• Ashley Flint, LMSW

  • Clinical Social Worker
  • North Chili, NY
  • NPI 1982072781

  NC

  Medicare reassignment NPD
• Julie Park Gehrke, OTR

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1164414082
  NPD (past)
• Jennifer Lynne Shai, LCSW

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1356627947
  NPD (past)
• Frances Jacobs Smith, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1700090032
  NPD (past)
• Racine E Johnson, DPT/OT

  • Orthopedic Physical Therapist
  • Atlanta, GA
  • NPI 1407022064
  NPD (past)

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1780684522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6853 FAIRVIEW RD",
            "address_2": "STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103363",
            "telephone_number": "704-366-9930",
            "fax_number": "704-366-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6853 FAIRVIEW RD",
            "address_2": "SUITE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103363",
            "telephone_number": "704-366-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAD INJURY CENTER OF CHARLOTTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "EWERT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-366-9930",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina NeuroServices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna Taylor Hayworth, RPH
• Catherine Pattison Hazelton, PA
• Matthew Alan Hazle, MD
• HCC - Healthcare of Charlotte, LLC (Elizabeth Place)
• Hdholistic Education Services
• Mary C Head, NP
• Headed N Positive Directions
• Angela Headen, CEO
• Raven Headen
• Heading in the Right Direction

• Adult Mental Health Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.