Carolina Mercy Medical Clinic PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

200100074 Issued in NC

Legal business name

CAROLINA MERCY MEDICAL CLINIC PC

Practice address

2101 W Franklin Blvd
Gastonia, NC 28052-1338

Phone

(704) 867-8855

Fax

(704) 867-1414

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Cornelius S Okonkwo, D.ONPI 1134235369

Title

Director

Phone

(704) 867-8855

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Cornelius S Okonkwo, DO

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1134235369
  Medicare reassignment NPD Authorized official
• Irving A Williams, M.D.

  • Internal Medicine Physician
  • Shelby, NC
  • NPI 1144208422
  NPD (past)

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1104154988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W FRANKLIN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280521338",
            "telephone_number": "704-867-8855",
            "fax_number": "704-867-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W FRANKLIN BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280521338",
            "telephone_number": "704-867-8855",
            "fax_number": "704-867-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA MERCY MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "OKONKWO",
        "authorized_official_first_name": "CORNELIUS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-867-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "200100074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Community Services
• Carolina Crisis Support
• Carolina Digestive Diseases Center, PC
• Carolina Family Network & Therapeutic SVC
• Carolina Home Care Solutions, Inc
• Carolina Neurological Consulting, PLLC
• Carolina Orthopaedic & Sports Medicine Center PA
• Carolina Orthopaedic & Sports Medicine Center, P.a.
• Carolina Orthopaedic & Sports Medicine Center, P.a.
• Carolina Pediatric Center, PLLC

• Primary Care Clinic/Center in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.