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

Active since December 22, 2010CLIA 34D1079319 · Waiver
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: August 02, 2026.

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

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 holds a CLIA Waiver certificate valid through October 18, 2026, 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
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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

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
Active · expires 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.

Does Charlotte Radiology PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1079319) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.