Organization Active NPI

Carolina Joint and Arthritis Clinic

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1053905158
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAROLINA JOINT AND ARTHRITIS CLINIC
Practice address
5725 Oleander Dr Ste E4
Wilmington, NC 28403-4746
Phone
(910) 769-7878
Fax
(910) 769-8967
NPI assigned
Mar 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Dr. Sherman Austin Yeargan III, MDNPI 1962421917
Title
Owner / Operator
Phone
(910) 398-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5725 Oleander Dr Ste E4
Wilmington, NC 28403-4746

Mailing address

5725 Oleander Dr Ste E4
Wilmington, NC 28403-4746
Phone (910) 769-7878

Other names 1

  • Regenerative Medicine Clinic Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210416000455 NC Part B Supplier - Clinic/Group Practice 3678981412 Receives reassigned benefits from 2 practitioners
Practice locations: Wilmington, NC
O20231009000663 NC DME Supplier - Independently-Practicing Physical Therapist 3678981412 Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

5725 Oleander Dr
Ste E4
Wilmington, NC 28403
Phone (910) 769-7878

5725 Oleander Dr
Unit E
Wilmington, NC 28403
Phone (910) 769-7878

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1053905158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 OLEANDER DR STE E4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034746",
            "telephone_number": "910-769-7878",
            "fax_number": "910-769-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 OLEANDER DR STE E4",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034746",
            "telephone_number": "910-769-7878",
            "fax_number": "910-769-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA JOINT AND ARTHRITIS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "YEARGAN",
        "authorized_official_first_name": "SHERMAN",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER / OPERATOR",
        "authorized_official_telephone_number": "910-398-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regenerative Medicine Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.