SOUTH LAKE EARS NOSE & THROAT PA
NPI 1154695872
Otolaryngology in Huntersville, NC
About South Lake Ears Nose & Throat Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH LAKE EARS NOSE & THROAT PA (NPI 1154695872) is a healthcare organization registered as an otolaryngology in Huntersville, North Carolina and active in the NPI registry since February 2012. The organization lists Stan D Phillips, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Lake Ears Nose & Throat Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to South Lake Ears Nose & Throat PA, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 South Lake Ears Nose & Throat PA's NPI number?
The NPI number for South Lake Ears Nose & Throat PA is 1154695872. It was assigned to this organization in the NPPES registry on February 27, 2012.
Where is South Lake Ears Nose & Throat PA located?
South Lake Ears Nose & Throat PA is located at 9710 Sam Furr Rd Unit D, Huntersville, NC 28078. The listed phone number is (704) 896-1909.
What is South Lake Ears Nose & Throat PA's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is South Lake Ears Nose & Throat PA enrolled in Medicare?
Yes. South Lake Ears Nose & Throat PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Lake Ears Nose & Throat PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to South Lake Ears Nose & Throat PA, in Otolaryngology and Qualified Audiologist. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for South Lake Ears Nose & Throat PA was last updated on February 27, 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.
# South Lake Ears Nose & Throat Pa · NPI 1154695872
Otolaryngology organization in Huntersville, North Carolina. Organization record, active in the CMS NPPES registry since February 27, 2012.
## Identity
- **NPI:** 1154695872 (Entity type: Organization)
- **Enumerated:** February 27, 2012
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **Organization subpart:** No
- **Authorized official:** Stan Phillips, OWNER
## Practice location
- **Address:** 9710 SAM FURR RD UNIT D, Huntersville, NC 28078-4928
- **Phone:** (704) 896-1909 · **Fax:** (704) 896-1926
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Qualified Audiologist (2), Otolaryngology (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2012
- **Other identifiers:** Medicare UPIN G70963 (NC); Medicaid 891108A (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1154695872) · Data from the CMS NPPES public registry.