NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc

  • Internal Medicine Physician
  • Lenoir, NC
National Provider Identifier
1114935673
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC
Practice address
322 Mulberry St SW
Ste a
Lenoir, NC 28645-5702
Phone
(828) 757-6400
Fax
(828) 757-6424
NPI assigned
Aug 3, 2006
Organization subpart
Yes
Parent organization
CALDWELL MEMORIAL HOSPITAL, INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Karen Shadowens
Title
Cfo
Phone
(828) 757-5100

Other NPIs on the same Medicare enrollment 26

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

View all 26

Practitioners 59

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

View all 59

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0890789Robbins Medical Park322 Mulberry Street SW, Lenoir, NC 28645Certificate of waiverFeb 5, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000355 NC Part B Supplier - Clinic/Group Practice 5395646970 Receives reassigned benefits from 325 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lenoir, NC; Chapel Hill, NC; Blowing Rock, NC; Granite Falls, NC; Hickory, NC; Hudson, NC

National Provider Directory

National Provider Directory
Part of
Caldwell Mem Hosp

Locations

245 Winklers Creek Rd
Ste C
Boone, NC 28607
Phone (828) 262-1800

800 Eastowne Dr
Ste 100
Chapel Hill, NC 27514

1031 Morganton Blvd SW
Ste C
Lenoir, NC 28645
Phone (828) 757-8240

322 Mulberry St SW
Ste G
Lenoir, NC 28645
Phone (828) 757-6400

340 Peppers Ferry Rd
Wytheville, VA 24382
Phone (276) 228-3521

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X

Addresses

NPPES NPI Registry

Primary practice location

322 Mulberry St SW
Ste a
Lenoir, NC 28645-5702

Mailing address

321 Mulberry St SW
Medical Staff Services
Lenoir, NC 28645-5720
Phone (828) 757-5965

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
89011RAMedicaidNC
011T6OtherNCBCBS
DD8674OtherNCRR MEDICARE

Other names 1

NPPES NPI Registry
  • Robbins Medical Park Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 17, 2025.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1114935673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MULBERRY ST SW",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "828-757-5965",
            "fax_number": "828-757-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MULBERRY ST SW",
            "address_2": "STE A",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455702",
            "telephone_number": "828-757-6400",
            "fax_number": "828-757-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "SHADOWENS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "828-757-5100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011RA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "011T6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD8674",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Robbins Medical Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Robbins Medical Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lenoir, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.