Lee C Pederson (NPI# 1083690622, PAC ID# 5092789933) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1083690622 |
| PAC ID by PECOS | 5092789933 |
| Professional Enrollment ID | I20040825000669 |
| Full Name | Lee C Pederson |
| Organization Legal Name | SURGICAL SPECIALISTS OF CHARLOTTE PA |
| Address |
1918 Randolph Rd Suite 130 Charlotte NC 28207-1107 |
| Phone Number | 7043648100 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 3779519285 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340053 | NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER |
| 340113 | CAROLINAS MEDICAL CENTER/BEHAV HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 | 7043648100 | SURGICAL SPECIALISTS OF CHARLOTTE PA |
| Organization Legal Name | SURGICAL SPECIALISTS OF CHARLOTTE PA |
| Physicians | 40 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason S Burgess | General Surgery | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Iyore Amy Otabor James | General Surgery | Surgical Specialists of Charlotte Pa | 1450 Matthews Township Pkwy, Suite 250, Matthews, NC 28105-5331 |
| Krista E Stark | Physician Assistant | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Steven David Thies | General Surgery | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Shamly V Dhiman | General Surgery | Surgical Specialists of Charlotte Pa | 1721 Ebenezer Rd, Suite 175, Rock Hill, SC 29732-1188 |
| Lila Estelle Skropeta | Physician Assistant | Surgical Specialists of Charlotte Pa | 10030 Gilead Rd, Suite 245, Huntersville, NC 28078-7545 |
| Tammy Faw-severeide | Nurse Practitioner | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Jennifer Samples Holl | General Surgery | Surgical Specialists of Charlotte Pa | 1450 Matthews Township Pkwy, Suite 250, Matthews, NC 28105-5331 |
| Leah Michelle Miles | Physician Assistant | Surgical Specialists of Charlotte Pa | 10030 Gilead Rd, Suite 245, Huntersville, NC 28078-7545 |
| Cara Elizabeth Hudson | General Surgery | Surgical Specialists of Charlotte Pa | 1450 Matthews Township Pkwy, Suite 250, Matthews, NC 28105-5331 |
| Street Address |
1918 RANDOLPH RD SUITE 130 |
| City | CHARLOTTE |
| State | NC |
| Zip | 28207-1107 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thamrah Rhoxana Wright | Family Medicine | Novant Medical Group Inc | 1918 Randolph Rd, Suite 275, Charlotte, NC 28207-1109 |
| Aileen Deng | Internal Medicine | The Presbyterian Hospital | 1918 Randolph Rd, Suite 350, Charlotte, NC 28207-1111 |
| Adam F Spitz | Endocrinology | Novant Medical Group Inc | 1918 Randolph Rd, Suite 220, Charlotte, NC 28207-1109 |
| Sachin J Hansalia | Pulmonary Disease | Novant Medical Group Inc | 1918 Randolph Rd, Suite 580, Charlotte, NC 28207-1116 |
| Christopher D Ferris | Gastroenterology | Tryon Medical Partners, Pllc | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Jason S Burgess | General Surgery | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| John S Dawson | Family Medicine | Carolina Medicorp Enterprises, Inc. | 1918 Randolph Rd, Suite 175, Charlotte, NC 28207-1107 |
| Rupal N Badalyan | Internal Medicine | Tryon Medical Partners, Pllc | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Meredith J Faulkner | Internal Medicine | Tryon Medical Partners, Pllc | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Krista E Stark | Physician Assistant | Surgical Specialists of Charlotte Pa | 1918 Randolph Rd, Suite 130, Charlotte, NC 28207-1107 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin M Rudisel | Internal Medicine | Novant Medical Group Inc | 1901 Randolph Rd, Charlotte, NC 28207-1101 |
| Philip M Dayvault | Physician Assistant | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Tyler L Carllee | Orthopedic Surgery | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Lindsay C Collins | Physician Assistant | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Kristen L Alford | Physical Therapy | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Marcie Heslop Siebert | Occupational Therapy | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Eric C Heckman | Physician Assistant | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Shannon Mullaly | Physical Therapy | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Timothy A Boyd | Physician Assistant | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Raymond G Gaston | Hand Surgery | Orthocarolina, Pa | 1915 Randolph Rd, Charlotte, NC 28207-1101 |
| Find all physicians in zip 28207 | |||
| City | CHARLOTTE |
| Zip Code | 28207 |
| Specialty | GENERAL SURGERY |
| City + Specialty | CHARLOTTE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Lee C Pederson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.