DR. GLEN ROY PINKSTON JR. (NPI# 1912904517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912904517 |
| Entity Type | Individual |
| Full Name | DR. GLEN ROY PINKSTON JR. |
| Credential | M.D. |
| Practice Address |
8800 N Tryon St Charlotte NC 28262-3300 |
| Mailing Address |
Po Box 30637 Charlotte NC 28230-0637 |
| Practice Telephone | 7048635727 |
| Practice Fax Number | 7048635733 |
| Mailing Telephone | 7049735500 |
| Mailing Fax Number | 7049735518 |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2018-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
2011-00931 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | STATE MEDICAL BOARD | 34437 | 01 |
| SC | NC1429 | 05 | |
| NC | STATE MEDICAL BOARD | 2011-00931 | 01 |
| NC | 5917687 | 05 |
| Street Address |
8800 N TRYON ST |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-3300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912485046 | Melanie Taylor | Nurse Practitioner | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2018-07-31 |
| 1285149377 | Eric Nathan Stipec | Nurse Anesthetist, Certified Registered | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2017-12-11 |
| 1972050888 | Kerri Kilburn Whitley | Registered Nurse | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2016-09-08 |
| 1376096669 | Andrew Bullaro | Nurse Practitioner | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2016-08-03 |
| 1437505583 | Michael William Bryant | Emergency Medicine | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2016-05-08 |
| 1043677743 | Julie Price Laskey | Physician Assistant | 8800 N Tryon St, Charlotte, NC 28262 | 2016-01-26 |
| 1124404405 | Carolinas Physicians Network Inc | Internal Medicine | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2015-08-10 |
| 1144602103 | Crawley Memorial Hospital, Inc. | Long Term Care Hospital | 8800 N Tryon St, Ltach-4th Floor, Charlotte, NC 28262-3300 | 2015-06-25 |
| 1598156234 | The Charlotte Mecklenburg Hospital Authority | Nurse Anesthetist, Certified Registered | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2015-02-17 |
| 1134510878 | The Charlotte-mecklenburg Hospital Authority | General Practice | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2015-02-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
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| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316401375 | Celligent Diagnostics, LLC | Pathology | 101 E W T Harris Blvd Ste 1212, Charlotte, NC 28262-3423 | 2019-01-24 |
| 1093716599 | James Dwayne Dollar | Pathology | 1000 Blythe Blvd Fl 4, Charlotte, NC 28203-5812 | 2005-08-09 |
| 1013913128 | Patrick Aloysius Wilson | Pathology | 200 Hawthorne Ln, Presbyterian Hospital Department of Pathology, Charlotte, NC 28204-2515 | 2005-06-23 |
| 1154586345 | Michal Kamionek | Pathology | 1000 Blythe Blvd, 4th Floor- Department of Patholoty, Charlotte, NC 28203 | 2008-07-28 |
| 1972778488 | Michael James Shealy | Pathology | 2001 Vail Ave, Charlotte, NC 28207-1248 | 2008-04-25 |
| 1215100664 | Trisha Miller Shattuck | Pathology | 1000 Blythe Blvd Fl 4, Charlotte, NC 28203-5812 | 2008-04-07 |
| 1750425138 | Emily C. Gaston | Pathology | 1000 Blythe Blvd Fl 4, Charlotte, NC 28203 | 2007-02-17 |
| 1669569448 | Chad A. Livasy | Pathology | 1000 Blythe Blvd Fl 4, Charlotte, NC 28203-5812 | 2006-10-05 |
| 1548278252 | William A Ahrens | Pathology | 1000 Blythe Blvd, Pathology, Charlotte, NC 28203-5812 | 2006-08-04 |
| 1285690990 | Foster Jerome Sanders Jr. | Pathology | 200 Hawthorne Lane, Charlotte, NC 28204 | 2006-04-21 |
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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.