DR. DOUGLAS LEE BOERTJE MD NPI 1558361246

NPI Information

  • NPI: 1558361246
  • Provider Name: DR. DOUGLAS LEE BOERTJE, MD
  • Classification: Emergency Medicine - 207PP0204X
  • Specialization: Pediatric Emergency Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 501 S SHARON AMITY RD STE 300
    CHARLOTTE, NC
    ZIP 28211
  • Phone: (704) 377-2424

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NPI Details

DR. Douglas Lee Boertje, MD is a pediatric emergency medicine emergency medicine in Charlotte, NC. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. DR. Douglas Lee Boertje, MD NPI is 1558361246. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

501 S SHARON AMITY RD STE 300
CHARLOTTE, NC
ZIP 28211-035
Phone: (704) 377-2424
Fax: (704) 377-2687

The NPI 1558361246 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 8/23/2023.

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
1207PP0204XEmergency MedicinePediatric Emergency Medicine2006-01516NORTH CAROLINAYes
2207PP0204XEmergency MedicinePediatric Emergency Medicine36257TENNESSEENo

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
1N01517OTHERSOUTH CAROLINASC MEDICAID
259-05661MEDICAIDNORTH 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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