Organization Active NPI

The Presbyterian Hospital

  • Hematology & Oncology Physician
  • Charlotte, NC
National Provider Identifier
1992290357
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
THE PRESBYTERIAN HOSPITAL
Practice address
8401 University Exec Park Dr Ste 130
Charlotte, NC 28262-4358
Phone
(980) 302-7050
Fax
(980) 302-7055
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Leea Jeanine Walton
Title
RCS Manager
Phone
(704) 316-6081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

8401 University Exec Park Dr Ste 130
Charlotte, NC 28262-4358

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health Cancer Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223001121 NC Part B Supplier - Clinic/Group Practice 1153231907 Receives reassigned benefits from 988 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC; Cornelius, NC; Huntersville, NC; Matthews, NC; Monroe, NC; Mooresville, NC

Other NPIs on the same Medicare enrollment 34

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

View all 34

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2155018Novant Health Cancer Institute University8401 University Executive Park Drive, Suite 130, Charlotte, NC 28262AccreditationJan 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Hosp Sup51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

8401 University Exec Park Dr
Ste 130
Charlotte, NC 28262
Phone (704) 316-2016

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1992290357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 UNIVERSITY EXEC PARK DR STE 130",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624358",
            "telephone_number": "980-302-7050",
            "fax_number": "980-302-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "LEEA",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-316-6081"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Cancer Institute",
            "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 Jul 10, 2023; 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.