Atrium Health Huntersville ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ATRIUM HEALTH HUNTERSVILLE ASC, LLC

Doing business as

Huntersville Surgery Center

Practice address

16455 Statesville Rd Ste 100
Huntersville, NC 28078-7137

Phone

(704) 801-1701

Fax

(704) 987-8403

NPI assigned

Jun 3, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Jean Louise Wildasin, RN

Title

Administrator

Phone

(704) 801-1701

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Huntersville Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Atrium Health Huntersville ASC LLC Dba Huntersville Surgery CenterCCN 34C0001230

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

Member of 1

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

• The Charlotte-Mecklenburg Hospital Authority

  • Psychiatric Hospital Unit
  • Concord, NC
  • NPI 1629283866

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1952977563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16455 STATESVILLE RD STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787137",
            "telephone_number": "704-801-1701",
            "fax_number": "704-987-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16455 STATESVILLE RD STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787137",
            "telephone_number": "704-801-1701",
            "fax_number": "704-987-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATRIUM HEALTH HUNTERSVILLE ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2024-01-19",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "WILDASIN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-801-1701",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "9999999999999999",
            "identifier": "999999999999999999",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.thomas@atriumhealth.org",
            "affiliation": "N",
            "endpointDescription": "Administrator e-mail",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Contact only, no medical record content",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Contact only",
            "address_1": "16455 Statesville Rd Ste 100",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Huntersville Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Huntersville, NC
• Providers in Huntersville, 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 Jan 19, 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.