NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Lenoir, NC
National Provider Identifier
1114974029
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H0061 Issued in NC
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC.
Practice address
321 Mulberry Street, SW
Lenoir, NC 28645-5720
Phone
(828) 757-5100
Fax
(828) 757-5512
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Mrs. Karen Shadowens
Title
Cfo
Phone
(828) 757-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H0061 NC Primary

Addresses

Primary practice location

321 Mulberry Street, SW
Lenoir, NC 28645-5720

Mailing address

321 Mulberry Street, SW
Lenoir, NC 28645-5720
Phone (828) 757-5100

Other identifiers 2

IdentifierTypeStateIssuer
00078OtherNCBCBS
3400041MedicaidNC

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000854 NC Part A Provider - Hospital 5395646970 Practice locations: Granite Falls, NC; Lenoir, NC; Hudson, NC; Hickory, NC; Blowing Rock, NC

Hospital certification: CCN 340041

Legal name
CALDWELL MEMORIAL HOSPITAL INC
Doing business as
UNC HEALTH CALDWELL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 11, 1998
Beds
110
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Dec 8, 1945 in NC
Enrollment address
321 Mulberry St SW
Lenoir, NC 28645-5720
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit

Other NPIs with the same Medicare PAC ID 12

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Caldwell Memorial HospitalCCN 340041
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
34D2046546Caldwell Unc Health Care Cardiac Cath Lab321 Mulberry Street SW, Suite 477, Lenoir, NC 28645AccreditationJul 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Caldwell Mem Hosp26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
April Moore Individual Corporate DirectorBoard Member Jan 1, 2026
Muriel Kay Gaither Individual Corporate DirectorBoard Member Jan 1, 2023
Kevin Lynn McDougall Individual Corporate DirectorBoard Member Jan 1, 2023
Robert Floyd Individual Corporate DirectorBoard Member Jan 1, 2022
Jerrell Elliott Suddreth Individual Corporate DirectorCno Jan 6, 2023
Michele Hannah Jones Individual W-2 Managing EmployeePractice Admin Sep 28, 2014
University of North Carolina Health Care System Organization, Morrisville, NC 5% Or Greater Indirect Ownership Interest May 1, 2013 100%
Operational/Managerial Control May 1, 2013 100%
Joseph Lindsey Gibbons Individual Corporate OfficerBoard Member Jan 1, 2016
Brandi Douglas Cook Individual W-2 Managing EmployeeClinic Manager, Radiology Sep 1, 2024
Karen Shadowens Individual Corporate OfficerCfo May 16, 2022
Jerry Thomas Church Individual Corporate Director Jan 1, 2019
Janet Deal Aiken Individual Corporate DirectorBod Jan 14, 2020
David a Lowry Individual Corporate OfficerCeo Aug 1, 2017
Terry William Hunt Individual Corporate DirectorBoard Member Jan 1, 2021
Douglas Wayne Johnson Individual Corporate DirectorBoard Member Jan 1, 2018
Bradley Thomas Christoph Individual Corporate DirectorBoard Member Sep 1, 2025
David Smith Individual Corporate DirectorBoard Member Jan 1, 2018
Elizabeth Paige Darnell Individual Corporate DirectorBoard Member Jan 1, 2026
Mark Jeffrey Poarch Individual Corporate DirectorBoard Jan 1, 2021
Cristen Parker Page Individual Corporate OfficerCeo Unc Health Care System Nov 1, 2023
Sarah Young Individual Corporate OfficerCmo Apr 1, 2024

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 43

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 43

Practitioners & affiliated clinicians

Practitioners 212

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

View all 212

Affiliated clinicians 307

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

View all 307

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1114974029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MULBERRY STREET, SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "828-757-5100",
            "fax_number": "828-757-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MULBERRY STREET, SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "828-757-5100",
            "fax_number": "828-757-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "H0061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00078",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400041",
            "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": "5221 Paramount Pkwy Ste 440",
            "city": "Morrisville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275605491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

Verify at the official NPI Registry.