PROFESSIONAL FEES
NPI 1063910404
Nurse Anesthetist, Certified Registered in Charlotte, NC

Q: What is Novant Health Mint Hill Medical Center, LLC's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since January 31, 2018CLIA Certified · 4 labs

8201 HEALTHCARE LOOP, CHARLOTTE, NC 28215(980) 302-1000(980) 302-1001 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 5, 2020, Jan 9, 2019, Mar 15, 2018 (3 updates tracked since 2018).

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About Professional Fees NPPES

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

PROFESSIONAL FEES (NPI 1063910404) is a healthcare organization registered as a nurse anesthetist, certified registered in Charlotte, North Carolina and active in the NPI registry since January 2018. The organization holds 4 active CLIA laboratory certificates and lists Allison Joy Greear, Pres & Coo, as its authorized official.

NPPES Registry Identity

NPI1063910404

Entity TypeOrganization

Primary Taxonomy367500000X

Legal Business NameNOVANT HEALTH MINT HILL MEDICAL CENTER, LLC

Location Address8201 HEALTHCARE LOOPCharlotte, NC 28215-7072

Mailing Address2085 Frontis Plaza BlvdWinston Salem, NC 27103-5614 · (336) 277-7226 · Fax (336) 277-9795

Phone(980) 302-1000

Fax(980) 302-1001

Organization SubpartNo

Authorized OfficialAllison Joy GreearPres & Coo · (704) 384-4089

Enumeration DateJanuary 31, 2018

Last NPPES UpdateFebruary 5, 20203 updates tracked since enumeration

✔ NPI 1063910404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

8201 HEALTHCARE LOOP, Charlotte, NC 28215

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Other Names 1

Doing Business AsProfessional Fees

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 4

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 Accreditation 34D2144482

Novant Health Mint Hill Medical Center Laboratory · Charlotte, NC

Active · expires Sep 10, 2027

CLIA Number34D2144482

Laboratory TypeHospital

Certificate Effective DateSeptember 11, 2025

Certificate Expiration DateSeptember 10, 2027

Laboratory DirectorDr. Patrick L. Ware

Laboratory Phone(704) 384-3762

Laboratory LocationNovant Health Mint Hill Medical Center Laboratory8201 Healthcare Loop, Charlotte, NC 28215

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 34D2144484

Novant Health Mint Hill Medical Center Blood Gas Laboratory · Charlotte, NC

Active · expires Sep 2, 2027

CLIA Number34D2144484

Laboratory TypeHospital

Certificate Effective DateSeptember 3, 2025

Certificate Expiration DateSeptember 2, 2027

Laboratory DirectorDr. Jessica Gruenberg

Laboratory Phone(704) 384-0547

Laboratory LocationNovant Health Mint Hill Medical Center Blood Gas Laboratory8201 Healthcare Loop, Charlotte, NC 28215

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 34D2325182

Novant Health Mint Hill Medical Center - Nursing · Charlotte, NC

Active · expires Jun 8, 2027

CLIA Number34D2325182

Laboratory TypeIndustrial

Certificate Effective DateJune 9, 2025

Certificate Expiration DateJune 8, 2027

Laboratory DirectorPatrick L. Ware

Laboratory Phone(704) 384-0547

Laboratory LocationNovant Health Mint Hill Medical Center - Nursing8201 Healthcare Loop, Charlotte, NC 28215

CLIA data matches this NPI record on: Address Name

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

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D2197823

Novant Health Mint Hill Medical Center · Charlotte, NC

Active · expires Oct 27, 2026

CLIA Number34D2197823

Laboratory TypeHospital

Certificate Effective DateOctober 28, 2024

Certificate Expiration DateOctober 27, 2026

Laboratory DirectorChristopher Chandler

Laboratory Phone(336) 718-6424

Laboratory LocationNovant Health Mint Hill Medical Center8201 Healthcare Loop, Charlotte, NC 28215

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAI PRASANNA VANAM MD

Internal Medicine (Cardiovascular Disease)