NPIMap

Organization Active NPI

Carolina Ear, Nose & Throat-Sinus and Allergy Center PA

  • Otolaryngology Physician
  • Morganton, NC
National Provider Identifier
1043555899
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
Practice address
149 W Parker Rd
Suite C
Morganton, NC 28655-4673
Phone
(828) 322-2183
Fax
(828) 322-2389
NPI assigned
Dec 5, 2012
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Brook Fulmer
Title
Business Office
Phone
(828) 322-2183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

149 W Parker Rd
Suite C
Morganton, NC 28655-4673

Mailing address

256 10TH Ave NE Ste C
Hickory, NC 28601-3882
Phone (828) 322-2183

Other identifiers 1

IdentifierTypeStateIssuer
890298QMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100724000089 NC Part B Supplier - Clinic/Group Practice 9830101476 Receives reassigned benefits from 23 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hickory, NC; Lenoir, NC; Lincolnton, NC; Morganton, NC

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2196592Carolina ENT Sinus and Allergy Center, PA149 West Parker Rd, Suite C, Morganton, NC 28655Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Carolina Ear Nose Throat-S7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1043555899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 10TH AVE NE STE C",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013882",
            "telephone_number": "828-322-2183",
            "fax_number": "828-322-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 W PARKER RD",
            "address_2": "SUITE C",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554673",
            "telephone_number": "828-322-2183",
            "fax_number": "828-322-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "BROOK",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "828-322-2183"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890298Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.