Glen Roy Pinkston Jr., M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2011-00931 Issued in NC

Practice address

8800 N Tryon St
Charlotte, NC 28262-3300

Phone

(704) 863-5727

Fax

(704) 863-5733

NPI assigned

Jun 29, 2005

Last updated

Apr 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: gpinkston500144@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolinas Pathology Group, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Spartanburg, SC
  • NPI 1730324583
  NPD (past)

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1912904517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30637",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282300637",
            "telephone_number": "704-973-5500",
            "fax_number": "704-973-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623300",
            "telephone_number": "704-863-5727",
            "fax_number": "704-863-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "GLEN",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-29",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2011-00931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917687",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1429",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD",
            "identifier": "34437",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD",
            "identifier": "2011-00931",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pink Elephant Community & Family Services LLC
• Yolanda M Pinkney-Coleman, MENTAL HEALTH COACH
• Amonna Pinkney
• Jireh E Pinkney, RBT
• Quenesha Deshawn Pinkney, LCSW-A
• Pinnacle Care PLLC
• Pinnacle Family Services of North Carolina LLC
• Pinnacle Life Innovations LLC
• Pinnacle Medical Clinic, P.a.
• Pinnacle Physicians Network, PA

• Anatomic Pathology & Clinical Pathology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.