CAROLINAS MEDICAL CENTER (NPI# 1346547809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346547809 |
| Entity Type | Organization |
| Organization Name | CAROLINAS MEDICAL CENTER |
| Other Organization Name | CAROLINAS BANK AND SPORTS SPECIALISTS |
| Practice Address |
332 Sam Newell Rd Suite 1200 Matthews NC 28105-6566 |
| Mailing Address |
Po Box 601372 Charlotte NC 28260-1372 |
| Practice Telephone | 7045124400 |
| Practice Fax Number | 7045124401 |
| Mailing Telephone | 7045124400 |
| Mailing Fax Number | 7045124401 |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2016-08-10 |
| Authorized Official Name | MR. THOMAS FORD LAYMON (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7046310002 |
| Is Organization Subpart | Y |
| Parent Organization Name | CAROLINAS MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5903972 | 05 | |
| SC | NPB197 | 05 |
| Other Name | Type Code |
|---|---|
| Carolinas Bank and Sports Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871998575 | Carolinas Medical Center | General Acute Care Hospital | 2001 Vail Ave., Charlotte, NC 28207-1219 | 2014-10-24 |
| 1750546347 | Carolinas Medical Center | Clinic/Center | 1216 North Tryon Street, Behavioral Health Center Cmc Randolph, Charlotte, NC 28206-3256 | 2008-07-23 |
| 1366558959 | Carolinas Medical Center | Pharmacy | 1350 S Kings Dr Ste 101, Charlotte, NC 28207-2134 | 2006-08-23 |
| 1063900405 | Carolinas Medical Center | Internal Medicine | 126 Milestone Way, Greenville, SC 29615-5065 | 2018-05-01 |
| 1780197335 | Carolinas Medical Center | Internal Medicine | 11 Gateway Corners Park, Columbia, SC 29203-8902 | 2017-11-06 |
| 1578086187 | Carolinas Medical Center | Internal Medicine | 10502 Park Rd, Suite 110, Charlotte, NC 28210-8479 | 2017-07-25 |
| 1821467911 | Carolinas Medical Center | General Acute Care Hospital | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2015-09-18 |
| 1346648235 | Carolinas Medical Center | General Acute Care Hospital | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2014-12-09 |
| 1962825166 | Carolinas Medical Center | Surgery | 200 Medical Park Dr, Ste 320, Concord, NC 28025-2982 | 2014-01-24 |
| 1851712582 | Carolinas Medical Center | Family Medicine | 10650 Park Rd, Charlotte, NC 28210-8538 | 2013-12-24 |
| Street Address |
332 SAM NEWELL RD SUITE 1200 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124096953 | Kevyn Miller | Physician Assistant | 332 Sam Newell Rd, Suite 1100, Matthews, NC 28105-6566 | 2006-03-09 |
| 1770859126 | Charlotte Mecklenburg Hospital Authority | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2012-03-30 |
| 1699085605 | Carolinas Physicians Network Inc | Family Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2010-10-13 |
| 1710202163 | Mecklenburg Medical Group | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2010-03-29 |
| 1194854778 | Catherine Janell Tewolde | Nurse Practitioner | 332 Sam Newell Rd, Matthews, NC 28105-6566 | 2007-03-02 |
| 1568561330 | Leigh Sullivan Clavin | Pharmacist | 332 Sam Newell Rd, Matthews, NC 28105 | 2006-09-21 |
| 1790709210 | John E. Davenport | Internal Medicine | 332 Sam Newell Rd, Suite 2000, Matthews, NC 28105-6566 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679130744 | Mojo Sportclinic, LLC | Physical Medicine & Rehabilitation | 6859 Monument Dr, Wilmington, NC 28405-4178 | 2019-05-23 |
| 1679138176 | Jeneva Gatses | Physical Medicine & Rehabilitation | 13759 Cinnabar Pl, Huntersville, NC 28078-5342 | 2019-05-09 |
| 1285159905 | Austin John Hille | Physical Medicine & Rehabilitation | 400 Landis Ct. #203, Asheville, NC 28806 | 2017-08-03 |
| 1174052138 | Olivia Sabo | Physical Medicine & Rehabilitation | 8814 Red Rd, Rockwell, NC 28138-6500 | 2017-06-05 |
| 1770180903 | Kenneth Lassiter | Physical Medicine & Rehabilitation | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2020-10-01 |
| 1588296719 | Douglas Maccallum | Physical Medicine & Rehabilitation | 2121 E Williams St Ste 108, Apex, NC 27539-7765 | 2020-02-05 |
| 1972153419 | Meredith Elise Bland | Physical Medicine & Rehabilitation | 3475 Erwin Rd, Durham, NC 27705-0005 | 2019-09-17 |
| 1275188484 | Edward Albert Marshall Jr. | Physical Medicine & Rehabilitation | 224 East Wilson Street, Wingate, NC 28174 | 2019-08-05 |
| 1881174878 | Jaela Marie Wilson | Physical Medicine & Rehabilitation | 1801 Fayetteville St, Durham, NC 27707-3129 | 2018-08-19 |
| 1841784170 | Jordan Drew Bettleyon | Physical Medicine & Rehabilitation | 5400 Ramsey St, Fayetteville, NC 28311 | 2018-06-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.