CAROLINAS MEDICAL CENTER (NPI# 1609174515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609174515 |
| Entity Type | Organization |
| Organization Name | CAROLINAS MEDICAL CENTER |
| Other Organization Name | CAROLINAS BACK AND SPORTS SPECIALISTS |
| Practice Address |
1106 Reynolds St Suite 200 Monroe NC 28112-4375 |
| 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 | 2011-03-02 |
| Last Update Date | 2011-03-02 |
| Authorized Official Name | DENNIE UNDERWOOD (VICE PRESIDENT) |
| Authorized Official Telephone | 7043553147 |
| 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 |
| Other Name | Type Code |
|---|---|
| Carolinas Back 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 |
1106 REYNOLDS ST SUITE 200 |
| City | MONROE |
| State | NC |
| Zip Code | 28112-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427083526 | Chandrashekhar Patil | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2006-07-11 |
| 1598297764 | Joseph Milner | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2017-03-28 |
| 1952755043 | Milele Likivu Kudumu Bynum | Family Medicine | 1106 Reynolds St, Monroe, NC 28112-4375 | 2016-04-15 |
| 1962815308 | Nelius Macharia | Family Medicine | 1106 Reynolds St, Monroe, NC 28112-4375 | 2014-06-03 |
| 1184036212 | Christopher Vieau | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2014-05-23 |
| 1376898148 | Carolinas Physicians Network Inc | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2012-07-18 |
| 1689936676 | Holly Stegall | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2012-06-14 |
| 1235424144 | Brittany Behm | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2011-06-20 |
| 1083930580 | Jamalia Junelle David | Family Medicine | 1106 Reynolds St, Monroe, NC 28112-4375 | 2010-04-09 |
| 1548497381 | Benjamin Simmons IIi | Family Medicine | 1106 Reynolds St, Ste 100, Monroe, NC 28112-4375 | 2009-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000620 | Paladina Health, LLC | Family Medicine | Paladina Health Monroe Campus Park, 1640 A Campus Park Drive, Monroe, NC 28112 | 2019-02-22 |
| 1073078408 | Sharelle Monique Hatley | Social Worker | 501 North Charlotte Ave, Suite C-214, Monroe, NC 28112 | 2019-02-11 |
| 1740762509 | Fox Counseling and Consulting, Pllc | Social Worker | 311 W Jefferson Street, Monroe, NC 28112 | 2018-08-29 |
| 1760976062 | Kinena J Dent-smith | Community/Behavioral Health | 207 Raymond St, Monroe, NC 28112 | 2018-06-20 |
| 1093225468 | Healthstat Onsite Clinic Parkdale Plant 21 | Preventive Medicine | 5005 Waxhaw Highway 75, Monroe, NC 28112 | 2017-10-11 |
| 1871026567 | H.o.p.e. Advancement, Inc. | Counselor | 349 Venus Street, Monroe, NC 28112 | 2017-04-10 |
| 1508304650 | Monroe Dental Clinic General Partnership | Dentist | 102 E Windsor Street, Monroe, NC 28112 | 2017-02-09 |
| 1073062865 | Garahetta Robin Sell | Massage Therapist | 600 West End Drive, Monroe, NC 28112 | 2016-09-22 |
| 1700280765 | Katherine Hartness | Massage Therapist | 205 N. Hayne St., Monroe, NC 28112 | 2014-10-20 |
| 1346655586 | Gaurav Chand | Internal Medicine | 1663 Campus Park Dr., Suite D, Monroe, NC 28112 | 2014-06-26 |
| Find all providers in zip 28112 | ||||
| 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 |
|---|---|---|---|---|
| 1104342385 | Justin Alexander Rohrman | Physical Medicine & Rehabilitation | 308 Warhawk Way, Monroe, LA 71203 | 2017-08-18 |
| 1154704724 | Victoria Hamby | Physical Medicine & Rehabilitation | 1501 Louisville Ave, Monroe, LA 71201-6025 | 2015-07-01 |
| 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.