CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA - NPI 1366793465

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

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

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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 1366793465) is a healthcare organization registered as an otolaryngology in Mooresville, North Carolina and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through November 17, 2026 and lists Jag S Gill, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366793465

Entity TypeOrganization

Primary Taxonomy207Y00000X

Legal Business NameCHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA

Location Address144 FOUNTAIN PLMooresville, NC 28117-0162

Mailing Address6035 Fairview RdCharlotte, NC 28210-3256 · (704) 295-3000 · Fax (704) 295-3468

Phone(704) 658-0595

Fax(704) 658-0916

Organization SubpartNo

Authorized OfficialJag S GillCeo · (704) 295-3000

Enumeration DateSeptember 28, 2012

Last NPPES UpdateSeptember 12, 2024

NPPES CertifiedSeptember 12, 2024

✔ NPI 1366793465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedOtolaryngology · Facial Plastic SurgeryTaxonomy 207YS0123X

Also ListedAudiologistTaxonomy 231H00000X

Also ListedAudiologist-Hearing Aid FitterTaxonomy 237600000X

144 FOUNTAIN PL, Mooresville, NC 28117

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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 34D2122073

Charlotte Eye Ear Nose & Throat Associates, PA · Mooresville, NC

Active · expires Nov 17, 2026

CLIA Number34D2122073

Laboratory TypePhysician Office

Certificate Effective DateNovember 18, 2024

Certificate Expiration DateNovember 17, 2026

Laboratory DirectorRoy S. Lewis

Laboratory Phone(704) 658-0595

Laboratory LocationCharlotte Eye Ear Nose & Throat Associates, PA144 Fountain Place, Mooresville, NC 28117

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MS. KATHERINE GRACE DUNCAN PA-C

Physician Assistant