CHARLOTTE RADIOLOGY PA NPI 1003110677

NPI Information

  • NPI: 1003110677
  • Provider Name: CHARLOTTE RADIOLOGY PA
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 34D0996589
  • Address: 1025 MOREHEAD MEDICAL DR STE 150
    CHARLOTTE, NC
    ZIP 28204
  • Phone: (704) 362-5391

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NPI Details

CHARLOTTE RADIOLOGY PA is a diagnostic radiology radiology in Charlotte, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. CHARLOTTE RADIOLOGY PA NPI is 1003110677. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1025 MOREHEAD MEDICAL DR STE 150
CHARLOTTE, NC
ZIP 28204-973
Phone: (704) 362-5391

The provider's authorized official is Jane T Lutz .
The authorized official title is Manager Payer Privileging and has the following contact phone number (704) 362-5391.

The CLIA number assigned to this NPI record is 34D0996589 - school/student health service with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Screening 3d breast mammography (HCPCS:77063)
  • Screening mammography (HCPCS:77067)

The enumeration date for this NPI number is 12/22/2010 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00921619OTHERNORTH CAROLINARR MEDICARE
25916456MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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