Carolina Anti-Aging & Wellness Center PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

39413 Issued in NC

Legal business name

CAROLINA ANTI-AGING & WELLNESS CENTER PA

Practice address

1227 Carthage St
Sanford, NC 27330-8984

Phone

(919) 774-0502

Fax

(919) 774-0505

NPI assigned

May 28, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Watson Durham, MD

Title

President

Phone

(919) 774-0502

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1013142488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273308984",
            "telephone_number": "919-774-0502",
            "fax_number": "919-774-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 CARTHAGE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273308984",
            "telephone_number": "919-774-0502",
            "fax_number": "919-774-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA ANTI-AGING & WELLNESS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "WATSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-774-0502",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "39413",
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NC",
            "license": "39413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caring 4 All and More
• Caring Hands of Lee County
• Caring Hands Physical Therapy, LLC
• Sydney Carlson
• Amanda Carluccio
• Carolina Brain Wellness Center PLLC
• Carolina Dialysis, LLC (Carolina Dialysis- Lee County)
• Carolina Dialysis, LLC (Carolina Dialysis - Sanford)
• Carolina Eye Associates Inc (Carolina Eye Associates PA)
• Carolina Internal Medicine Center PA

• Primary Care Clinic/Center in Sanford, NC
• Providers in Sanford, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.