NPIMap

Organization Active NPI

Caromont Medical Group, Inc.

  • Surgery Physician
  • Gastonia, NC
National Provider Identifier
1093063398
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAROMONT MEDICAL GROUP, INC.
Practice address
2391 Court Dr Ste 105
Gastonia, NC 28054-2197
Phone
(704) 671-7390
Fax
(704) 671-7396
NPI assigned
Aug 17, 2012
Organization subpart
Yes
Parent organization
CAROMONT MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Authorized official

Name
David Michael Oconnor
Title
Cfo
Phone
(704) 671-5343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2391 Court Dr Ste 105
Gastonia, NC 28054-2197

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other practice location 1

2000 Caromont Pkwy Ste 202
Belmont, NC 28012-0158
Phone (704) 671-7390

Other identifiers 3

IdentifierTypeStateIssuer
1093063398MedicaidNC
NPA699MedicaidSC
027CCOtherNCBCBS OF NC

Other names 1

  • CaroMont Breast Surgical Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031201000070 NC Part B Supplier - Clinic/Group Practice 3577476258 Receives reassigned benefits from 760 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Kings Mountain, NC; Lenoir, NC; McAdenville, NC; Morganton, NC; Shelby, NC; Stanley, NC; Belmont, NC…
O20041021000318 SC Part B Supplier - Clinic/Group Practice 3577476258 Receives reassigned benefits from 59 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clover, SC; Lake Wylie, SC

National Provider Directory

National Provider Directory
Part of
Gaston Health Resources

Locations

2000 Caromont Pkwy
Ste 200
Belmont, NC 28012
Phone (704) 834-3278

2240 Remount Rd
Ste 200
Gastonia, NC 28054
Phone (704) 783-4354

Other NPIs on the same Medicare enrollment 8

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

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1093063398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 COURT DR STE 105",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542197",
            "telephone_number": "704-671-7390",
            "fax_number": "704-671-7396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Caromont Pkwy Ste 202",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280120158",
            "country_code": "US",
            "telephone_number": "704-671-7390",
            "fax_number": "704-671-7396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROMONT MEDICAL GROUP INC",
        "enumeration_date": "2012-08-17",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-671-5343"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093063398",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPA699",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "027CC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CaroMont Breast Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.