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BALLANTYNE MEDICAL ASSOCIATES PLLC
NPI 1114290632
Non-Pharmacy Dispensing Site in Charlotte, NC

Active since February 14, 2012CLIA Certified · 2 labs
12311 COPPER WAY, SUITE 100, CHARLOTTE, NC 28277(704) 540-1640 Get Directions Write a Review

NPPES record last updated: February 14, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ballantyne Medical Associates Pllc NPPES

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

BALLANTYNE MEDICAL ASSOCIATES PLLC (NPI 1114290632) is a healthcare organization registered as a non-pharmacy dispensing site in Charlotte, North Carolina and active in the NPI registry since February 2012. The organization holds 2 active CLIA laboratory certificates and lists Carlos Jorge, Owner, as its authorized official.

NPPES Registry Identity

NPI1114290632
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameBALLANTYNE MEDICAL ASSOCIATES PLLC
Location Address12311 COPPER WAY, SUITE 100Charlotte, NC 28277-3642
Mailing Address2980 N Beverly Glen Cir, Suite 301Los Angeles, CA 90077-1726 · (310) 474-9809
Phone(704) 540-1640
Organization SubpartYes
Authorized OfficialCarlos JorgeOwner · (704) 540-1640
Enumeration DateFebruary 14, 2012
✔ NPI 1114290632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
12311 COPPER WAY, Charlotte, NC 28277
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CLIA Laboratory Certificates CMS CLIA 2

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 34D2005822

Ballantyne Medical Associates · Charlotte, NC
Active · expires Apr 5, 2028
CLIA Number34D2005822
Laboratory TypePhysician Office
Certificate Effective DateApril 6, 2026
Certificate Expiration DateApril 5, 2028
Laboratory DirectorSteven R. Bauer
Laboratory Phone(704) 540-1640
Laboratory LocationBallantyne Medical Associates15640 Don Lochman Lane Suite A, Charlotte, NC 28277
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2144738

Ballantyne Medical Associates, PLLC · Charlotte, NC
Active · expires Sep 17, 2026
CLIA Number34D2144738
Laboratory TypePhysician Office
Certificate Effective DateSeptember 18, 2024
Certificate Expiration DateSeptember 17, 2026
Laboratory DirectorSteven Bauer
Laboratory Phone(704) 540-1640
Laboratory LocationBallantyne Medical Associates, PLLC16928 Lancaster Highway, Suite 105, Charlotte, NC 28277
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
12311 COPPER WAY, SUITE 200-A
CHARLOTTE, NC 28277
Mecklenburg County (704) 403-2660
DR. AMIT MAHESH PATEL M.D.
Internal Medicine (Rheumatology)
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-2916
DR. STEVEN ROBERT BAUER
Family Medicine
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 540-1640
BALLANTYNE MEDICAL ASSOCIATES PLLC
Family Medicine
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 540-1640
SALLY E HARRILL PT
Physical Therapist
12311 COPPER WAY, SUITE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 541-8788
CAROLINA ANALGESIC INC
Durable Medical Equipment & Medical Supplies
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 644-1508
MIRA SANJAY PATEL PA-C
Physician Assistant
12311 COPPER WAY
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-0820
USHA BALMURI MD
Family Medicine
12311 COPPER WAY, STE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-0820

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 Ballantyne Medical Associates PLLC's NPI number?

The NPI number for Ballantyne Medical Associates PLLC is 1114290632. It was assigned to this organization in the NPPES registry on February 14, 2012.

Where is Ballantyne Medical Associates PLLC located?

Ballantyne Medical Associates PLLC is located at 12311 Copper Way Suite 100, Charlotte, NC 28277. The listed phone number is (704) 540-1640.

What is Ballantyne Medical Associates PLLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Ballantyne Medical Associates PLLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Ballantyne Medical Associates PLLC was last updated on February 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.