CHARLOTTE RADIOLOGY PA
NPI 1003110677
Radiology - Diagnostic Radiology in Charlotte, NC

Q: What is Charlotte Radiology PA's NPI number?

The NPI number for Charlotte Radiology PA is 1003110677. It was assigned to this organization in the NPPES registry on December 22, 2010.

Q: What is Charlotte Radiology PA's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Active since December 22, 2010

1025 MOREHEAD MEDICAL DR STE 150, CHARLOTTE, NC 28204(704) 362-5391 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 17, 2018, Jul 26, 2017 (2 updates tracked since 2017).

On this page

About Charlotte Radiology Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLOTTE RADIOLOGY PA (NPI 1003110677) is a healthcare organization registered as a diagnostic radiology in Charlotte, North Carolina and active in the NPI registry since December 2010. The organization maintains 2 additional practice locations and lists Jane T Lutz, Manager Payer Privileging, as its authorized official.

NPPES Registry Identity

NPI1003110677

Entity TypeOrganization

Primary Taxonomy2085R0202X

Legal Business NameCHARLOTTE RADIOLOGY PA

Location Address1025 MOREHEAD MEDICAL DR STE 150Charlotte, NC 28204-2973

Mailing Address700 E Morehead St Ste 300Charlotte, NC 28202-2742 · (704) 334-7800 · Fax (704) 414-7512

Phone(704) 362-5391

Organization SubpartNo

Authorized OfficialJane T LutzManager Payer Privileging · (704) 362-5391

Enumeration DateDecember 22, 2010

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1003110677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

1025 MOREHEAD MEDICAL DR STE 150, Charlotte, NC 28204

Open in Google Maps ↗

Secondary Practice Locations 2

Location 13816 Latrobe DrCharlotte, NC 28211-1167 · Phone (704) 909-5960 · Fax (704) 770-0501

Location 2700 E Morehead St Ste 300Charlotte, NC 28202-2742 · Phone (704) 334-7800 · Fax (704) 414-7512

Other Identifiers 2

OtherP00921619NC · Rr Medicare

Medicaid5916456NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charlotte Radiology Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNorth CarolinaEnrollment IDO20110309000931Non-DME Part B · Mammography CenterDue dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D1079319

Charlotte Radiology Breast Center - Mmp · Charlotte, NC

Expired · Oct 18, 2026

CLIA Number34D1079319

Laboratory TypeOther

Certificate Effective DateOctober 19, 2024

Certificate Expiration DateOctober 18, 2026

Laboratory DirectorDr. Deborah Agisim

Laboratory Phone(704) 362-5391

Laboratory LocationCharlotte Radiology Breast Center - Mmp1025 Morehead Medical Drive, Suite 150, Charlotte, NC 28204

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Screening 3d breast mammography 77063

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

175 services175 patients

Screening mammography 77067

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

175 services175 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlotte Radiology PA's NPI number?

The NPI number for Charlotte Radiology PA is 1003110677. It was assigned to this organization in the NPPES registry on December 22, 2010.

Where is Charlotte Radiology PA located?

Charlotte Radiology PA is located at 1025 Morehead Medical Dr Ste 150, Charlotte, NC 28204. The listed phone number is (704) 362-5391.

What is Charlotte Radiology PA's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Charlotte Radiology PA enrolled in Medicare?

Yes. Charlotte Radiology PA is registered in the Medicare PECOS enrollment system.

When is Charlotte Radiology PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Mammography Center) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Charlotte Radiology PA accept?

Health plans from Blue Cross and Blue Shield of NC list Charlotte Radiology PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charlotte Radiology PA was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.