Charlotte Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AS0026 Issued in NC

Legal business name

CHARLOTTE SURGERY CENTER, LLC

Practice address

2825 Randolph Rd
Charlotte, NC 28211-1075

Phone

(704) 377-1647

NPI assigned

Apr 20, 2006

Organization subpart

No

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

Authorized official

Name

Thomas Lally

Title

Chief Administrative Officer

Phone

(704) 377-1647

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Charlotte Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1124594338

  8820196538

  Same PAC ID

Listed as

Charlotte Surgery Center LLC Dba Charlotte Surgery Center Museum CampusCCN 34C0001016

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Healthsouth Surgery Cen2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1124594338
  NPD tax ID

Member of 2

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

• Orthocarolina, PA

  • Physician Assistant
  • Jefferson, NC
  • NPI 1619217551

  Member Of

  NPD member
• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866

  Member Of

  NPD member

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Charlotte Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1124594338
  NPPES parent name

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1891750998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111018",
            "telephone_number": "704-377-1674",
            "fax_number": "704-358-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111075",
            "telephone_number": "704-377-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "LALLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "704-377-1647"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "AS0026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409842",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charlotte Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charlotte Speech and Hearing Center
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• Charlotte Sports Performance and Rehab, LLC
• Charlotte Surgery Center, LLC
• Charlotte Therapy Associates
• Charlotte Transportation Inc
• Charlotte Trauma Services, PLLC
• Charlotte True Health Chiropractic, PLLC
• Charlotte Uptown Chauffeurs LLC

• 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 Oct 15, 2018; 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.