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CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
NPI 1154516201
Ophthalmology in Statesville, NC

Active since September 12, 2007CLIA 34D1054060 · Waiver
646 HARTNESS RD, STATESVILLE, NC 28677(704) 295-3000(704) 838-8494 Get Directions Write a Review

NPPES record last updated: January 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charlotte Eye Ear Nose & Throat Associates, Pa NPPES

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

CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA (NPI 1154516201) is a healthcare organization registered as an ophthalmology in Statesville, North Carolina and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through May 9, 2028 and lists Jag S Gill, Ceo, as its authorized official.

NPPES Registry Identity

NPI1154516201
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameCHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Location Address646 HARTNESS RDStatesville, NC 28677-3423
Mailing Address6035 Fairview RoadCharlotte, NC 28210-3256 · (704) 295-3000 · Fax (704) 838-8494
Phone(704) 295-3000
Fax(704) 838-8494
Organization SubpartNo
Authorized OfficialJag S GillCeo · (704) 295-3000
Enumeration DateSeptember 12, 2007
Last NPPES UpdateJanuary 23, 2024
NPPES CertifiedJanuary 23, 2024
✔ NPI 1154516201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOtolaryngologyTaxonomy 207Y00000X
646 HARTNESS RD, Statesville, NC 28677
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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 34D1054060

Charlotte Eye Ear Nose & Throat Associates PA · Statesville, NC
Active · expires May 9, 2028
CLIA Number34D1054060
Laboratory TypePhysician Office
Certificate Effective DateMay 10, 2026
Certificate Expiration DateMay 9, 2028
Laboratory DirectorCraig Self
Laboratory Phone(704) 295-3390
Laboratory LocationCharlotte Eye Ear Nose & Throat Associates PA646 Hartness Road, Statesville, NC 28677
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

DR. CRAIG S SELF MD
Ophthalmology
646 HARTNESS RD
STATESVILLE, NC 28677
Iredell County (704) 872-4108
DR. WALTER BOWLIN HOLLAND M.D.
Ophthalmology
646 HARTNESS RD
STATESVILLE, NC 28677
Iredell County (704) 872-4108
RACHEL PECK SABO MD
Ophthalmology
646 HARTNESS RD
STATESVILLE, NC 28677
Iredell County (704) 872-4108
DR. BRENT BLAIR WARREN MD
Ophthalmology
646 HARTNESS RD
STATESVILLE, NC 28677
Iredell County (704) 872-4108

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 Eye Ear Nose & Throat Associates, PA's NPI number?

The NPI number for Charlotte Eye Ear Nose & Throat Associates, PA is 1154516201. It was assigned to this organization in the NPPES registry on September 12, 2007.

Where is Charlotte Eye Ear Nose & Throat Associates, PA located?

Charlotte Eye Ear Nose & Throat Associates, PA is located at 646 Hartness Rd, Statesville, NC 28677. The listed phone number is (704) 295-3000.

What is Charlotte Eye Ear Nose & Throat Associates, PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Charlotte Eye Ear Nose & Throat Associates, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1054060) is associated with this NPI, valid through May 9, 2028. 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 Eye Ear Nose & Throat Associates, PA was last updated on January 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.