CAROLINAS MEDICAL CENTER (NPI# 1467790055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467790055 |
| Entity Type | Organization |
| Organization Name | CAROLINAS MEDICAL CENTER |
| Other Organization Name | CMC WOMEN'S CENTER FOR PELVIC HEALTH NORTHEAST |
| Practice Address |
200 Medical Park Dr Ste 250 Concord NC 28025-2982 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 7044036350 |
| Mailing Telephone | 7046310002 |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | THOMAS LAYMON (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 7044468250 |
| Is Organization Subpart | Y |
| Parent Organization Name | CAROLINAS MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CMC Women's Center for Pelvic Health Northeast | Doing Business As Name - Organization |
| CMC Women's Center for Pelvic Health Northeast | Other Name - Individual/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 |
200 MEDICAL PARK DR STE 250 |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-2982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245040 | Myron Roddenberry | Physician Assistant | 200 Medical Park Dr, Suite 230, Concord, NC 28025-2982 | 2005-06-17 |
| 1679183776 | Carolinas Physicians Network Inc | Orthopaedic Surgery | 200 Medical Park Dr, Ste 500, Concord, NC 28025-2982 | 2020-08-04 |
| 1518577832 | Leah Mccain | Nurse Practitioner | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2020-08-01 |
| 1477198091 | Ryan Cannici | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2019-11-07 |
| 1881159341 | Jessica Surane | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2019-02-08 |
| 1740756253 | Samantha Mason | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-10-23 |
| 1700361466 | Montana Poe | Nurse Practitioner | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2018-09-28 |
| 1932695574 | Stephanie White | Nurse Practitioner | 200 Medical Park Dr, Ste 430, Concord, NC 28025-2982 | 2018-07-06 |
| 1487185534 | Mukunda Singh | Internal Medicine | 200 Medical Park Dr, Ste 550, Concord, NC 28025-2982 | 2017-03-21 |
| 1497207641 | Jessica Marchal | Physician Assistant | 200 Medical Park Dr, Ste 230, Concord, NC 28025-2982 | 2016-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508220773 | Vivian Ojeda | Obstetrics & Gynecology | 246 Pleasant St, Memorail Building, West, Floor 1, Concord, NH 03301-2548 | 2016-04-13 |
| 1265758460 | John A Crockett Md A Professional Corporation | Obstetrics & Gynecology | 2485 High School Ave Ste 303, Concord, CA 94520-1818 | 2010-04-13 |
| 1730335910 | Joanne A. Schoen | Obstetrics & Gynecology | 7625 Gentry Circle, Concord, OH 44077 | 2008-08-07 |
| 1790806941 | Kenneth J Hekman | Obstetrics & Gynecology | 277 Deacon Haynes Rd, Concord, MA 01742-4757 | 2007-04-03 |
| 1891895686 | Anita K Rama, Md, Inc. | Obstetrics & Gynecology | 2425 East Street #14, Concord, CA 94520 | 2006-09-22 |
| 1285645556 | Mary Lucia | Obstetrics & Gynecology | 131 Old Road To 9 Acre Cor Ste 830, Concord, MA 01742-4191 | 2006-08-11 |
| 1902822083 | Chung Hwa Yi | Obstetrics & Gynecology | 246 Pleasant Street Memorial Building, West, Floor 1, Concord, NH 03301-5046 | 2006-07-14 |
| 1003854993 | Rebecca Anne Ewing | Obstetrics & Gynecology | 3 N State St, Concord, NH 03301-4037 | 2006-06-03 |
| 1811955628 | Timothy K Hale | Obstetrics & Gynecology | 131 Ornac Suite 430, Kramer Ob Gyn Emerson Hospital, Concord, MA 01742 | 2006-05-02 |
| 1316905391 | Cynthia Wesley | Obstetrics & Gynecology | 9955 Poplar Tent Rd, Concord, NC 28027 | 2006-05-01 |
| Find all providers in CONCORD | ||||
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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.