NPIMap

Organization Active NPI

Charlotte Colon & Rectal Surgery Associates PA

  • Colon & Rectal Surgery Physician
  • Charlotte, NC
National Provider Identifier
1831155738
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
40475 Issued in NC
Legal business name
CHARLOTTE COLON & RECTAL SURGERY ASSOCIATES PA
Practice address
2015 Randolph Rd
Suite 201
Charlotte, NC 28207-1200
Phone
(704) 333-1259
Fax
(704) 333-0371
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Dr. William Alfred Walker, M.D.NPI 1962493239
Title
President
Phone
(704) 333-1259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X 40475 NC Primary

Addresses

Primary practice location

2015 Randolph Rd
Suite 201
Charlotte, NC 28207-1200

Mailing address

2015 Randolph Rd
Suite 201
Charlotte, NC 28207-1200
Phone (704) 333-1259

Other identifiers 1

IdentifierTypeStateIssuer
8901403MedicaidNC

National Provider Directory

National Provider Directory

Locations

2015 Randolph Rd
Ste 201
Charlotte, NC 28207
Phone (704) 333-1259

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1831155738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071200",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071200",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE COLON & RECTAL SURGERY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ALFRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-333-1259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "40475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901403",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.