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HEALTHSTAT INC CCBCC CHARLOTTE MINI NPI 1164033767


NPI Information

NPI: 1164033767
Provider Name: HEALTHSTAT INC CCBCC CHARLOTTE MINI
Classification: Preventive Medicine - 2083P0500X
Entity Type: Organization

Specialization: Preventive Medicine/Occupational Environmental Medicine

CLIA Number: 34D2021419

Address:
801 BLACK SATCHEL RD
CHARLOTTE, NC
ZIP 28216
Phone: (980) 231-3507
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HEALTHSTAT INC CCBCC CHARLOTTE MINI is a preventive medicine/occupational environmental medicine preventive medicine in Charlotte, NC. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. HEALTHSTAT INC CCBCC CHARLOTTE MINI NPI is 1164033767. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

801 BLACK SATCHEL RD
CHARLOTTE, NC
ZIP 28216-453
Phone: (980) 231-3507

The provider's authorized official is Jill Johnson Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 34D2021419 - other - chrnc disease mgt clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2020 and was last updated on 8/17/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineYes

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: 4/28/2024

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