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SOUTHEAST RENAL ASSOCIATES PA
NPI 1073697553
Specialist in Charlotte, NC

Active since October 24, 2006
2301 W MOREHEAD ST, CHARLOTTE, NC 28208(704) 333-4217(704) 927-1767 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southeast Renal Associates Pa NPPES

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

SOUTHEAST RENAL ASSOCIATES PA (NPI 1073697553) is a healthcare organization registered as a specialist in Charlotte, North Carolina and active in the NPI registry since October 2006. The organization lists Jennifer Huneycutt, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1073697553
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHEAST RENAL ASSOCIATES PA
Location Address2301 W MOREHEAD STCharlotte, NC 28208-5178
Mailing Address2301 W Morehead StCharlotte, NC 28208-5178 · (704) 333-4217 · Fax (704) 927-1767
Phone(704) 333-4217
Fax(704) 927-1767
Organization SubpartNo
Authorized OfficialJennifer HuneycuttPractice Administrator · (704) 927-1755
Enumeration DateOctober 24, 2006
Last NPPES UpdateApril 20, 2008
✔ NPI 1073697553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2301 W MOREHEAD ST, Charlotte, NC 28208
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Other Identifiers 6

Other0109VNC · Bcbs Of Nc
Medicare ID-Type Unspecified8481SC · Sc Medicare
Medicare ID-Type UnspecifiedC13725NC · Rr Medicare
Medicare ID-Type Unspecified2312109NC · Cigna Medicare
MedicaidNPA650SC
Medicaid890109VNC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

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

SHEREE DANIELLE HARPER M.A., NCC, LPCA
Counselor (Professional)
2301 W MOREHEAD ST, SUITE B
CHARLOTTE, NC 28208
Mecklenburg County (704) 910-1122
CAROLINE STROUP
Community/Behavioral Health
2301 W MOREHEAD ST
CHARLOTTE, NC 28208
Mecklenburg County (704) 910-1122
MEDLAB TREATMENT CENTER
Internal Medicine
2301 W MOREHEAD ST, SUITE A
CHARLOTTE, NC 28208
Mecklenburg County (704) 332-3800
MS. YOLONDA TINDAL MSW, LCSWA
Social Worker (Clinical)
2301 W MOREHEAD ST, SUITE B
CHARLOTTE, NC 28208
Mecklenburg County (704) 910-1122
AMY LEIGH MOCK MA, LPC
Counselor (Mental Health)
2301 W MOREHEAD ST, SUITE B
CHARLOTTE, NC 28208
Mecklenburg County (704) 497-0824
PROCURE THERAPEUTIC AGENCY, INC
Community/Behavioral Health
2301 W MOREHEAD ST, SUITE B
CHARLOTTE, NC 28208
Mecklenburg County (704) 910-1122
LONDON ALLEN PERRY
Social Worker (Clinical)
2301 W MOREHEAD ST
CHARLOTTE, NC 28208
Mecklenburg County (704) 910-1122

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 Southeast Renal Associates PA's NPI number?

The NPI number for Southeast Renal Associates PA is 1073697553. It was assigned to this organization in the NPPES registry on October 24, 2006.

Where is Southeast Renal Associates PA located?

Southeast Renal Associates PA is located at 2301 W Morehead St, Charlotte, NC 28208. The listed phone number is (704) 333-4217.

What is Southeast Renal Associates PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southeast Renal Associates PA was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.