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NOVANT HEALTH BALLANTYNE OUTPATIENT SURGERY CRNA
NPI 1154857662
Nurse Anesthetist, Certified Registered in Charlotte, NC

Active since May 03, 2017CLIA 34D1066796 · Waiver
14215 BALLANTYNE CORPORATE PL STE 210, CHARLOTTE, NC 28277(704) 316-2650(704) 316-2653 Get Directions Write a Review

NPPES record last updated: December 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2019, Oct 4, 2018, May 24, 2018 (3 updates tracked since 2018).

About Novant Health Ballantyne Outpatient Surgery Crna NPPES

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

NOVANT HEALTH BALLANTYNE OUTPATIENT SURGERY CRNA (NPI 1154857662) is a healthcare organization registered as a nurse anesthetist, certified registered in Charlotte, North Carolina and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through April 2, 2027 and lists Fred M Hargett, Evp Cfo, as its authorized official.

NPPES Registry Identity

NPI1154857662
Entity TypeOrganization
Primary Taxonomy367500000X
Legal Business NamePRESBYTERIAN SAMEDAY SURGERY CENTER AT BALLANTYNE LLC
Location Address14215 BALLANTYNE CORPORATE PL STE 210Charlotte, NC 28277-3873
Mailing Address2085 Frontis Plaza BlvdWinston Salem, NC 27103-5614 · (336) 277-7226 · Fax (336) 277-9795
Phone(704) 316-2650
Fax(704) 316-2653
Organization SubpartNo
Authorized OfficialFred M HargettEvp Cfo · (704) 384-5184
Enumeration DateMay 3, 2017
Last NPPES UpdateDecember 18, 20193 updates tracked since enumeration
✔ NPI 1154857662 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.
14215 BALLANTYNE CORPORATE PL STE 210, Charlotte, NC 28277
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Other Names 1

Doing Business AsNovant Health Ballantyne Outpatient Surgery Crna

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 34D1066796

Novant Health Ballantyne Outpatient Surgery · Charlotte, NC
Active · expires Apr 2, 2027
CLIA Number34D1066796
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorJessica Mozdzen
Laboratory Phone(704) 316-2650
Laboratory LocationNovant Health Ballantyne Outpatient Surgery14215 Ballantyne Corporate Place, Sute 210, 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 3

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

TERESA GAYLE MCCORMICK
Nurse Anesthetist, Certified Registered
14215 BALLANTYNE CORPORATE PL STE 210
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-2650
LISA YONG KIMMERLE CRNA
Nurse Anesthetist, Certified Registered
14215 BALLANTYNE CORPORATE PL STE 210
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-2650
PRESBYTERIAN SAMEDAY SURGERY CENTER AT BALLANTYNE LLC
Clinic/Center (Ambulatory Surgical)
14215 BALLANTYNE CORPORATE PL STE 210
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-2650

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 Presbyterian Sameday Surgery Center At Ballantyne LLC's NPI number?

The NPI number for Presbyterian Sameday Surgery Center At Ballantyne LLC is 1154857662. It was assigned to this organization in the NPPES registry on May 3, 2017. The provider is doing business as Novant Health Ballantyne Outpatient Surgery Crna.

Where is Presbyterian Sameday Surgery Center At Ballantyne LLC located?

Presbyterian Sameday Surgery Center At Ballantyne LLC is located at 14215 Ballantyne Corporate Pl Ste 210, Charlotte, NC 28277. The listed phone number is (704) 316-2650.

What is Presbyterian Sameday Surgery Center At Ballantyne LLC's specialty?

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

Does Presbyterian Sameday Surgery Center At Ballantyne LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1066796) is associated with this NPI, valid through April 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Presbyterian Sameday Surgery Center At Ballantyne LLC was last updated on December 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.