CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY (NPI# 1356779169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356779169 |
| Entity Type | Organization |
| Organization Name | CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY |
| Practice Address |
2015 Randolph Rd Suite 208 Charlotte NC 28207-1128 |
| Mailing Address |
13808 Professional Center Dr Huntersville NC 28078-7948 |
| Practice Telephone | 7043774009 |
| Mailing Telephone | 7043774009 |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |
| Authorized Official Name | KATHY J SAMMIS (CEO) |
| Authorized Official Telephone | 7043774009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | L003016 | NC | Dietary & Nutritional Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC | 15830 John J Delany Dr Ste 175, Charlotte, NC 28277-3295 |
| Street Address |
2015 RANDOLPH RD SUITE 208 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493239 | William Alfred Walker | Colon & Rectal Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1200 | 2005-11-04 |
| 1508294687 | Jacquelyn Chandler Rupp | Dietitian, Registered | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2013-10-28 |
| 1083959282 | Novant Medical Group, Inc | Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1200 | 2012-11-29 |
| 1851548655 | Charlotte Gastroenterology & Hepatology, Pllc | Clinic/Center | 2015 Randolph Rd, Suite 101, Charlotte, NC 28207-1128 | 2008-08-22 |
| 1902934755 | Robert Stevens | Surgery | 2015 Randolph Rd, Suite 201, Charlotte, NC 28207-1128 | 2007-03-02 |
| 1073603486 | Jason A Wilson | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2006-10-14 |
| 1730100801 | Charlotte Gastroenterology & Hepatology, Pllc | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1128 | 2006-07-22 |
| 1003854860 | Marcie Lynne Pickett | Nurse Practitioner | 2015 Randolph Rd, Ste 208, Charlotte, NC 28207-1200 | 2006-06-03 |
| 1285682443 | David G Scholz | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1200 | 2006-05-04 |
| 1619925419 | John Gardiner R Roddey Jr. | Internal Medicine | 2015 Randolph Rd, Suite 208, Charlotte, NC 28207-1200 | 2006-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502081 | Leslie Thompson Van Horn | Dietitian, Registered | 7722 Quail Park Dr, Charlotte, NC 28210-6928 | 2020-09-14 |
| 1679188064 | Taryn Mattern | Dietitian, Registered | 4617 Dabney Vigor Dr, Charlotte, NC 28209-2839 | 2020-09-11 |
| 1508478017 | Katelin Emproto | Dietitian, Registered | 13521 Steelecroft Pkwy Unit D, Charlotte, NC 28278-7551 | 2020-08-18 |
| 1699386169 | Sequoia A Ridley | Dietitian, Registered | 7015 Berolina Ln Apt 1536, Charlotte, NC 28226-8710 | 2020-08-10 |
| 1396360954 | Madalyn Quinn | Dietitian, Registered | 309 S Sharon Amity Rd Ste 102, Charlotte, NC 28211-2886 | 2020-06-10 |
| 1578185567 | Madison Nancy Dodsworth | Dietitian, Registered | 11519 Painted Tree Rd, Charlotte, NC 28226-3841 | 2020-05-12 |
| 1356962203 | Lucy Price Hooper | Dietitian, Registered | 507 Queens Rd Apt 405, Charlotte, NC 28207-1592 | 2020-05-01 |
| 1457984478 | Tara Lavelle | Dietitian, Registered | 5434 Dockery Dr, Charlotte, NC 28209-3672 | 2020-02-18 |
| 1265072664 | Melanie Romano | Dietitian, Registered | 7733 Ballantyne Commons Pkwy Ste 201-i, Charlotte, NC 28277-4396 | 2020-01-14 |
| 1669016804 | Michael Decaro | Dietitian, Registered | 309 S Sharon Amity Rd Ste 101, Charlotte, NC 28211-2978 | 2019-10-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.