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General NPI Number Information
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NPI Number | 1740172295
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Entity Type | Organization
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Legal Business Name | GREATER CHARLOTTE SEDATION ASSOCIATES LLC
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 300 BILLINGSLEY RD STE 200B
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City | CHARLOTTE
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State | NC
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Zip | 28211-1075
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Country | US
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Telephone | 402-803-3885
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 739529
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City | DALLAS
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State | TX
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Zip | 75373-9529
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Country | US
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Telephone | 888-717-5383
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES KREGER
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Credential |
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Telephone | 205-999-4132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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