Healthcare Provider Details

I. General information

NPI: 1861538175
Provider Name (Legal Business Name): PLANNED PARENTHOOD SOUTH ATLANTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S TORRENCE ST
CHARLOTTE NC
28204-2928
US

IV. Provider business mailing address

100 S BOYLAN AVE
RALEIGH NC
27603-1802
US

V. Phone/Fax

Practice location:
  • Phone: 919-833-7526
  • Fax: 919-390-1384
Mailing address:
  • Phone: 919-833-7534
  • Fax: 919-833-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KARL LEVILLE
Title or Position: CFO
Credential:
Phone: 919-833-7526