Organization Active NPI

Carolinas Physicians Network, Inc.

Doing business as The Sanger Clinic

  • Pediatric Cardiology Physician
  • Indian Trail, NC
National Provider Identifier
1073838496
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
CAROLINAS PHYSICIANS NETWORK, INC.
Doing business as
The Sanger Clinic
Practice address
6030 West Highway 74
Suite F
Indian Trail, NC 28079-3469
Phone
(704) 373-0212
Fax
(704) 342-5871
NPI assigned
Mar 29, 2010
Last updated
Aug 17, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
Mr. Thomas Ford Laymon
Title
Senior Vice President
Phone
(704) 631-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X Primary

Addresses

Primary practice location

6030 West Highway 74
Suite F
Indian Trail, NC 28079-3469

Mailing address

PO Box 601067
Charlotte, NC 28260-1067
Phone (704) 373-0212

Other identifiers 2

IdentifierTypeStateIssuer
5905994MedicaidNC
NPB215MedicaidSC

Other names 1

  • The Sanger Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000455 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 1,949 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Diabetes Endocrine Osteopo

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1073838496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601067",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601067",
            "telephone_number": "704-373-0212",
            "fax_number": "704-342-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 WEST HIGHWAY 74",
            "address_2": "SUITE F",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793469",
            "telephone_number": "704-373-0212",
            "fax_number": "704-342-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2010-03-29",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-631-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905994",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB215",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sanger Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.