Active NPI
Cleco Primary Care Network
- Rural Health Clinic/Center
- Kings Mountain, NC
National Provider Identifier
1093795155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- CLECO PRIMARY CARE NETWORK
- Practice address
- 812 West King Street
Kings Mountain, NC 28086 - Phone
- (704) 480-9344
- Fax
- (704) 739-5271
- NPI assigned
- Jan 17, 2006
- Organization subpart
- Yes
- Parent organization
- CLECO PRIMARY CARE NETWORK
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Michelle Hoyle Jordan
- Title
- Financial Manager
- Phone
- (704) 480-1087
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
812 West King Street
Kings Mountain, NC 28086
Mailing address
808 Schenck St
Shelby, NC 28150-3934
Phone (704) 480-1087
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343963A | Medicaid | NC |
Other names 1
- Kings Mountain Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Rural health clinic certification: CCN 343963
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- KINGS MOUNTAIN MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Mar 3, 1995
- Last certification
- Oct 26, 2021
- Ownership / control type
- 2B
- Facility address
- 812 W King Street
Kings Mountain, NC 28086
National Provider Directory
National Provider Directory- Part of
- Cherryville Family
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553126400000",
"number": "1093795155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 SCHENCK ST",
"city": "SHELBY",
"state": "NC",
"postal_code": "281503934",
"telephone_number": "704-480-1087",
"fax_number": "704-484-3260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 WEST KING STREET",
"city": "KINGS MOUNTAIN",
"state": "NC",
"postal_code": "28086",
"telephone_number": "704-480-9344",
"fax_number": "704-739-5271"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLECO PRIMARY CARE NETWORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CLECO PRIMARY CARE NETWORK",
"enumeration_date": "2006-01-17",
"last_updated": "2019-03-21",
"status": "A",
"authorized_official_last_name": "JORDAN",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "HOYLE",
"authorized_official_title_or_position": "FINANCIAL MANAGER",
"authorized_official_telephone_number": "704-480-1087",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "343963A",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kings Mountain Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kings Mountain, NC
- John Allyn Cheshire III, PA-C
- Chiropractic Physicians of the Carolinas - Kings Mountain
- Tyler Chiste
- Christian G Anderson MD PA
- Clear View Optical LLC
- Cleveland County Healthcare System
- Cleveland County Healthcare System
- Cleveland County Healthcare System
- Cleveland County Healthcare System
- Cleveland County Healthcare System
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.