CAROLINA MEDICORP ENTERPRISES INC (NPI# 1417497504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417497504 |
| Entity Type | Organization |
| Organization Name | CAROLINA MEDICORP ENTERPRISES INC |
| Other Organization Name | NOVANT HEALTH PEDIATRIC URGENT CARE |
| Practice Address |
11840 Southmore Dr Ste 100 Charlotte NC 28277-4821 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 7043164440 |
| Mailing Telephone | 7043847976 |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2018-09-17 |
| Authorized Official Name | MR. GEOFFREY K GARDNER (VP FINANCE) |
| Authorized Official Telephone | 7043847976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health Pediatric Urgent Care | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8450 Park Rd, Charlotte, NC 282105801 | 7043847976 | 7043847977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659746576 | Carolina Medicorp Enterprises Inc | Family Medicine | 2620 N Main Street, Suite 109, High Point, NC 27265-2735 | 2015-12-03 |
| 1295106110 | Carolina Medicorp Enterprises Inc | Emergency Medicine | 50 W 4th St, Suite 10, Winston-salem, NC 27101-4089 | 2015-10-19 |
| 1063806792 | Carolina Medicorp Enterprises Inc | Family Medicine | 6816 Matthews-mint Hill Road, Suite 101, Mint Hill, NC 28227-9324 | 2015-03-19 |
| 1164815262 | Carolina Medicorp Enterprises Inc | Family Medicine | 480 Fletcher Dr, Suite 3, Warrenton, VA 20186-2185 | 2015-03-13 |
| 1003207960 | Carolina Medicorp Enterprises Inc | Family Medicine | 445 South Kings Drive, Charlotte, NC 28204-3041 | 2015-02-13 |
| 1548274327 | Carolina Medicorp Enterprises Inc | Family Medicine | 2000 Frontis Plaza Blvd Ste 200, Winston Salem, NC 27103-5616 | 2006-07-28 |
| 1922537612 | Carolina Medicorp Enterprises Inc | Clinic/Center | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2017-06-07 |
| 1841735024 | Carolina Medicorp Enterprises Inc | Pediatrics | 445 S Kings Dr, Charlotte, NC 28204-3041 | 2016-12-27 |
| 1689045239 | Carolina Medicorp Enterprises Inc | Family Medicine | 10322 Bristow Center Dr, Bristow, VA 20136-2201 | 2015-10-08 |
| 1447634191 | Carolina Medicorp Enterprises Inc | Emergency Medicine | 4012 Battleground Ave Ste B, 1020, Greensboro, NC 27410-8592 | 2015-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Carolina Medicorp Enterprises Inc. | 2626 Glenwood Ave Ste 550, Raleigh, NC 27608 |
| Virginia Business Entities | Carolina Medicorp Enterprises Inc. | 2085 Frontis Plaza Blvd, Winston-salem, North Carolina 27103 |
| Street Address |
11840 SOUTHMORE DR STE 100 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-4821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114917929 | Dean Lawrence Moniot | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4466 | 2005-10-24 |
| 1255806030 | Eileen Catherine Frager | Registered Nurse | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2018-10-09 |
| 1326527896 | Michael David Harrington II | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2018-08-07 |
| 1982120879 | Randall Pifer | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2017-08-22 |
| 1306361761 | Eleanor Rankin Pleasants | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277 | 2017-08-07 |
| 1346760675 | Trisha Ann Dmytruk | Obstetrics & Gynecology | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2017-06-27 |
| 1922537612 | Carolina Medicorp Enterprises Inc | Clinic/Center | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2017-06-07 |
| 1164823258 | Meghan Mckee | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2014-09-09 |
| 1114289634 | Stephanie Lauren Lewis Hart | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277 | 2012-06-11 |
| 1134239098 | Susan Mcrae | Physical Therapist | 11840 Southmore Dr Ste 100, Charlotte, NC 28277-4821 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| 1962042416 | Carolinas Physicians Network Inc | Pediatrics | 1308 Scott Ave, Charlotte, NC 28204-2918 | 2020-01-13 |
| 1083175533 | Denise Makala | Pediatrics | 1000 Blythe Blvd 4th Floor, Meb, Cmc/levine Children's Hospital, Charlotte, NC 28203-5812 | 2019-03-27 |
| 1639565526 | Emily Ogletree | Pediatrics | 8401 Medical Plaza Dr Ste 220, Charlotte, NC 28262-8700 | 2015-04-08 |
| 1811392343 | Adriana Virginia Rosado-jimenez | Pediatrics | 10340 Park Rd Ste B, Charlotte, NC 28210-8401 | 2014-10-27 |
| Find all providers in CHARLOTTE | ||||
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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.