Bethany Christian Services of NC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BETHANY CHRISTIAN SERVICES OF NC

Practice address

4944 Parkway Plaza Blvd Ste 190
Charlotte, NC 28217-1991

Phone

(704) 541-1833

Fax

(704) 919-5367

NPI assigned

May 26, 2021

Organization subpart

No

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

Authorized official

Name

Lisa Stoutmeyer

Title

Biller

Phone

(616) 224-7429

Specialties & licenses 1

Addresses

Tax ID family

Bethany Christian Services of NC2 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.

• Bethany Christian Services of NC

  • Multi-Specialty Clinic/Center
  • Raleigh, NC
  • NPI 1124586060
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Huggins

  • Clinical Social Worker
  • Cornelius, NC
  • NPI 1356967277
  NPD (past)
• Jacqueline Quartuccio, LCSW

  • Clinical Social Worker
  • Matthews, NC
  • NPI 1154944304
  NPD (past)

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1982279477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 PARKWAY PLAZA BLVD STE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171991",
            "telephone_number": "704-541-1833",
            "fax_number": "704-919-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944 PARKWAY PLAZA BLVD STE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171991",
            "telephone_number": "704-541-1833",
            "fax_number": "704-919-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY CHRISTIAN SERVICES OF NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "STOUTMEYER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "616-224-7429"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Alexander Betancourt, D.M.D.
• Luis Emilio Betancourt, M.D.
• Betancourt,Pinnix, Phelps, &Grimes, DMD PLLC
• Carolina Betancur
• Beth Brearley Parker, PHD PA
• Shar'Dasia V Bethea-Haynes
• Daren Z Bethea II, DC
• Kandra Bethea
• Quentin Bethea
• Bethel Homecare Inc

• Multi-Specialty Clinic/Center in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.