NPIMap

Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Atrium Health Endoscopy Center Kenilworth

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
National Provider Identifier
1861580870
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Atrium Health Endoscopy Center Kenilworth
Practice address
1225 Harding PL Ste 5200
Charlotte, NC 28204-2826
Phone
(704) 355-4178
Fax
(704) 355-4090
NPI assigned
Oct 11, 2006
Last updated
Jan 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Authorized official

Name
Rodney E. Ball
Title
Treasurer
Phone
(704) 403-1451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

1225 Harding PL Ste 5200
Charlotte, NC 28204-2826

Mailing address

1225 Harding PL Ste 5200
Charlotte, NC 28204-2826
Phone (704) 355-4178

Other names 1

  • Atrium Health Endoscopy Center Kenilworth Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070329000229 NC Part B Supplier - Ambulatory Surgical Center 3375449655 Receives reassigned benefits from 3 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Carolinas Physicians Network Inc Dba Carolinas Gastroenterology Medical Center PlazaCCN 34C0001138
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1000 Blythe Blvd
Ste 400
Charlotte, NC 28203

1225 Harding Pl
Ste 5200
Charlotte, NC 28204
Phone (704) 355-4178

Practitioners & affiliated clinicians

Practitioners 3

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1861580870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 HARDING PL STE 5200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042826",
            "telephone_number": "704-355-4178",
            "fax_number": "704-355-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HARDING PL STE 5200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042826",
            "telephone_number": "704-355-4178",
            "fax_number": "704-355-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "704-403-1451"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atrium Health Endoscopy Center Kenilworth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.