NPIMap

Organization Active NPI

Duke Health Lake Norman Regional Medical Center, Inc.

Doing business as Duke Health Lake Norman Hospital

  • General Acute Care Hospital
  • Mooresville, NC
National Provider Identifier
1114731064
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DUKE HEALTH LAKE NORMAN REGIONAL MEDICAL CENTER, INC.
Doing business as
Duke Health Lake Norman Hospital
Practice address
171 Fairview Rd
Mooresville, NC 28117-9500
Phone
(704) 660-4000
NPI assigned
Feb 3, 2025
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Authorized official

Name
Nga Thach
Title
Chief of Staff, Finance
Phone
(919) 613-8902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

171 Fairview Rd
Mooresville, NC 28117-9500

Mailing address

PO Box 110566
Durham, NC 27709-5566
Phone (919) 620-5042

Other names 1

  • Duke Health Lake Norman Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250619001385 NC Part A Provider - Hospital 8224549878 Practice locations: Mooresville, NC
O20250626001545 NC Part A Provider - Hospital 8224549878 Practice locations: Mooresville, NC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1114731064. Details of each certification follow.

Hospital certification: CCN 340129

Legal name
DUKE HEALTH LAKE NORMAN REGIONAL MEDICAL CENTER, INC.
Doing business as
DUKE HEALTH LAKE NORMAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 11, 2015
Beds
105
Ownership / control type
Private (for profit)
Most recent change of ownership
Apr 1, 2025 (4 total)
Organization structure
CorporationNon-profit
Enrollment address
171 Fairview Rd
Mooresville, NC 28117-9500
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 34U129

Legal name
DUKE HEALTH LAKE NORMAN REGIONAL MEDICAL CENTER, INC.
Doing business as
DUKE HEALTH LAKE NORMAN HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
171 Fairview Rd
Mooresville, NC 28117-9500
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Duke Health Lake Norman HospitalCCN 340129 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Duke Health Lake Norman Regional Medical Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

131 Medical Park Rd
Fl 2
Mooresville, NC 28117
Phone (704) 660-2662

131 Medical Park Rd
Ste 101
Mooresville, NC 28117

131 Medical Park Rd
Ste 301A
Mooresville, NC 28117
Phone (704) 660-2676

145 Medical Park Rd
Ste 100
Mooresville, NC 28117
Phone (704) 660-4920

146 Medical Park Rd
Ste 100
Mooresville, NC 28117
Phone (704) 660-4920

146 Medical Park Rd
Ste 108
Mooresville, NC 28117
Phone (704) 662-0876

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas a Owens Individual Corporate OfficerSenior VP,Cfo & Treasurer Jul 1, 2011
Corporate OfficerSenior VP, Cfo & Treasurer Jul 1, 2011
Lisa M Goodlett Individual Corporate OfficerSenior VP,Cfo & Treasurer Apr 1, 2025
Corporate OfficerSenior VP, Cfo & Treasurer Apr 1, 2025
John Stuart Smith Individual Corporate OfficerVP Finance Oct 1, 2011
W-2 Managing EmployeeVP Finance Oct 1, 2011

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

Affiliated clinicians 236

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 236

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1114731064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110566",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277095566",
            "telephone_number": "919-620-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 FAIRVIEW RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179500",
            "telephone_number": "704-660-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUKE HEALTH LAKE NORMAN REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-03",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "THACH",
        "authorized_official_first_name": "NGA",
        "authorized_official_title_or_position": "CHIEF OF STAFF, FINANCE",
        "authorized_official_telephone_number": "919-613-8902"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duke Health Lake Norman Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.