Carolina Digestive Pathology Lab - Medicare Primary Care in Charlotte, NC

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Carolina Digestive Pathology Lab is a medicare enrolled primary clinic (Internal Medicine - Gastroenterology) in Charlotte, North Carolina. The current practice location for Carolina Digestive Pathology Lab is 300 Billingsley Rd Ste 200, Charlotte, North Carolina. For appointments, you can reach them via phone at (704) 372-7974. The mailing address for Carolina Digestive Pathology Lab is Po Box 96314, Charlotte, North Carolina and phone number is (704) 372-7974.

Carolina Digestive Pathology Lab is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1124052444. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (704) 372-7974.

Contact Information

Carolina Digestive Pathology Lab
300 Billingsley Rd Ste 200
Charlotte
NC 28211-1180
(704) 372-7974
(704) 372-8201

Map and Direction


Primary Care Clinic Profile

Full NameCarolina Digestive Pathology Lab
SpecialityInternal Medicine
Location300 Billingsley Rd Ste 200, Charlotte, North Carolina
Authorized Official Name and PositionJulie Rothrock (CREDENTIALING COORDINATOR)
Authorized Official Contact7043727974
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Carolina Digestive Pathology Lab
Po Box 96314
Charlotte
NC 28296-0314

Ph: (704) 372-7974		Carolina Digestive Pathology Lab
300 Billingsley Rd Ste 200
Charlotte
NC 28211-1180

Ph: (704) 372-7974

NPI Details:

NPI Number1124052444
Provider Enumeration Date07/11/2006
Last Update Date09/17/2024

Medicare PECOS Information:

Medicare PECOS PAC ID1951209790
Medicare Enrollment IDO20031230000650

Medical Identifiers

Medical identifiers for Carolina Digestive Pathology Lab such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124052444NPI-NPPES
7901569MedicaidNC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RG0100XInternal Medicine - Gastroenterology 40474 (North Carolina)Secondary
207RG0100XInternal Medicine - Gastroenterology (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Carolina Digestive Pathology Lab acts as a billing entity for following providers:
Provider NamePhyllis Bourn Arthur
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1982648283
PECOS PAC ID: 6406755792
Enrollment ID: I20040106000402
Provider NameDana B Pederson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1396787057
PECOS PAC ID: 7911892500
Enrollment ID: I20040223000041
Provider NameStephen Stephenson
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1376561613
PECOS PAC ID: 3274518253
Enrollment ID: I20040623000476
Provider NamePeter J Honerkamp
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1659395333
PECOS PAC ID: 1557338373
Enrollment ID: I20040913000263
Provider NameMichael Dixon
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1346260577
PECOS PAC ID: 4789644337
Enrollment ID: I20041018000683
Provider NameLynda W Lewis
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1053495481
PECOS PAC ID: 7012974017
Enrollment ID: I20041210000837
Provider NameJason Alex Espada
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1013932284
PECOS PAC ID: 6305895723
Enrollment ID: I20050112000958
Provider NameFred C Fowler
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1326066705
PECOS PAC ID: 0749230787
Enrollment ID: I20050127000055
Provider NameGlen L Portwood
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1316965726
PECOS PAC ID: 0345274908
Enrollment ID: I20050922000789
Provider NameKelly H Garmon
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1386677441
PECOS PAC ID: 1456364504
Enrollment ID: I20060713000289
Provider NameJeffrey Brian Pitman
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1699794909
PECOS PAC ID: 2860490927
Enrollment ID: I20061128000233
Provider NameEric B Thompson
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1972521219
PECOS PAC ID: 8224130661
Enrollment ID: I20070302000484
Provider NameRonnie Cyzner
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1528086980
PECOS PAC ID: 6305940818
Enrollment ID: I20070329000658
Provider NameStephen Deal
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1598783961
PECOS PAC ID: 0042314551
Enrollment ID: I20070731000686
Provider NameAnthony David Colvin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1831117324
PECOS PAC ID: 9133223647
Enrollment ID: I20070823000947
Provider NameTerri A Crockett
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1073532743
PECOS PAC ID: 7315035250
Enrollment ID: I20071110000152
Provider NameBruce Arakelian
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1376580886
PECOS PAC ID: 1658459722
Enrollment ID: I20080415000779
Provider NameRebecca A Fox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639351018
PECOS PAC ID: 9931287190
Enrollment ID: I20080429000307
Provider NameGeovanna O Deese
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558534768
PECOS PAC ID: 5092884346
Enrollment ID: I20080513000533
Provider NameJoshua B Kish
Provider TypePractitioner - Pathology
Provider IdentifiersNPI Number: 1225171622
PECOS PAC ID: 2466550595
Enrollment ID: I20080902000066
Provider NameLisa Y Kimmerle
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1124066881
PECOS PAC ID: 5294746368
Enrollment ID: I20091109000277
Provider NameAngela Annette Wilson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1477739035
PECOS PAC ID: 1153403340
Enrollment ID: I20100128000657
Provider NameTim D Wax
Provider TypePractitioner - Pathology
Provider IdentifiersNPI Number: 1881686178
PECOS PAC ID: 0648303115
Enrollment ID: I20100804000501
Provider NameBarry Randall Schneider
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1669490991
PECOS PAC ID: 4486758992
Enrollment ID: I20101023000016
Provider NameWilliam Kendall Couch
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1790080224
PECOS PAC ID: 2466634035
Enrollment ID: I20110303000727
Provider NameJames R Osborne
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1699078618
PECOS PAC ID: 6002098449
Enrollment ID: I20110307000862
Provider NameMary P Miles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205148624
PECOS PAC ID: 2466629357
Enrollment ID: I20120117000691
Provider NameAndrew B Cook
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1992074116
PECOS PAC ID: 9739349440
Enrollment ID: I20120404000213
Provider NameEmra M Hopkins
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1588936413
PECOS PAC ID: 9638330897
Enrollment ID: I20120416000021
Provider NameTarun Narang
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1205904448
PECOS PAC ID: 9133137359
Enrollment ID: I20130829000169
Provider NameNathan Allen Blake
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1548681828
PECOS PAC ID: 1254563414
Enrollment ID: I20140422002303
Provider NameRyan C Turk
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1063759751
PECOS PAC ID: 4880849090
Enrollment ID: I20140523001314
Provider NameDustin M Souther
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1144641788
PECOS PAC ID: 5597980524
Enrollment ID: I20140708001645
Provider NameAmy W Lee
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1508221763
PECOS PAC ID: 3072810456
Enrollment ID: I20160330001058
Provider NameJustin L Fletcher
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1023474756
PECOS PAC ID: 5597055723
Enrollment ID: I20160531002480
Provider NameMarcie W Le
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1194182170
PECOS PAC ID: 6002109790
Enrollment ID: I20160718001650
Provider NameDaphne Dihuei Yu
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1417314022
PECOS PAC ID: 6305144015
Enrollment ID: I20171003004736
Provider NamePhillip A Fink
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1124087432
PECOS PAC ID: 5597664730
Enrollment ID: I20180117000690
Provider NameGaurav Chand
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1346655586
PECOS PAC ID: 7416248885
Enrollment ID: I20180219001625
Provider NameOlanrewaju Yusuf Jimoh
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1053671586
PECOS PAC ID: 2163738626
Enrollment ID: I20180702000607
Provider NameAmber Lynn Busiek
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1255861266
PECOS PAC ID: 4183995467
Enrollment ID: I20181018002981
Provider NameColby Hollis
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1700366499
PECOS PAC ID: 6002158086
Enrollment ID: I20190423000380
Provider NameJohn King
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1609839836
PECOS PAC ID: 8820985856
Enrollment ID: I20190507001066
Provider NameHeather M. Gschnell
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1346505815
PECOS PAC ID: 8820247554
Enrollment ID: I20191205001839
Provider NameAdam Norman Beam
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1316585417
PECOS PAC ID: 9739514423
Enrollment ID: I20200128001000
Provider NameCaroline A. Miller
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1245870724
PECOS PAC ID: 6204263783
Enrollment ID: I20200221001892
Provider NameVictoria Maldonado Rothwell
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1316365067
PECOS PAC ID: 7719108042
Enrollment ID: I20200508000043
Provider NameKristin A Kapeles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205504891
PECOS PAC ID: 3678962180
Enrollment ID: I20211122001689
Provider NameSagar Patel
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1710349873
PECOS PAC ID: 7719272137
Enrollment ID: I20220316002530
Provider NameChristina Frances Christensen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114680311
PECOS PAC ID: 8527448083
Enrollment ID: I20220630002290
Provider NameHope Mancini Wood
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1023746633
PECOS PAC ID: 6608250048
Enrollment ID: I20220901003477
Provider NameGarrett S Greenan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225579584
PECOS PAC ID: 7911325931
Enrollment ID: I20230901003342
Provider NameThadeus Dapash
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1871976902
PECOS PAC ID: 3577871292
Enrollment ID: I20240424002475
Provider NameShixiong Liao
Provider TypePractitioner - Pathology
Provider IdentifiersNPI Number: 1285698829
PECOS PAC ID: 2961590286
Enrollment ID: I20240509002724

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.