Organization Active NPI

Salisbury Urological Clinic, PA

  • Urology Physician
  • Salisbury, NC
National Provider Identifier
1023091691
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SALISBURY UROLOGICAL CLINIC, PA
Practice address
911 W Henderson St
Ste 110
Salisbury, NC 28144-2736
Phone
(704) 633-9441
Fax
(704) 637-9006
NPI assigned
Nov 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Wayne Allen Cline Jr., MD
Title
President
Phone
(704) 633-9441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

911 W Henderson St
Ste 110
Salisbury, NC 28144-2736

Mailing address

911 W Henderson St
Ste 110
Salisbury, NC 28144-2736
Phone (704) 633-9441

Other identifiers 1

IdentifierTypeStateIssuer
8902595MedicaidNC

National Provider Directory

National Provider Directory

Locations

911 W Henderson St
Ste 110
Salisbury, NC 28144
Phone (704) 633-9441

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023091691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 W HENDERSON ST",
            "address_2": "STE 110",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442736",
            "telephone_number": "704-633-9441",
            "fax_number": "704-637-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W HENDERSON ST",
            "address_2": "STE 110",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442736",
            "telephone_number": "704-633-9441",
            "fax_number": "704-637-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALISBURY UROLOGICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLINE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-633-9441",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902595",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.