NPIMap

Organization Active NPI

Catawba Valley Medical Group, Inc

Doing business as Catawba Valley Family Medicine - Maiden

  • Family Medicine Physician
  • Maiden, NC
National Provider Identifier
1124305792
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CATAWBA VALLEY MEDICAL GROUP, INC
Doing business as
Catawba Valley Family Medicine - Maiden
Practice address
137 Island Ford Rd
Maiden, NC 28650-8735
Phone
(828) 732-5000
Fax
(828) 732-5001
NPI assigned
Nov 10, 2011
Last updated
Nov 17, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CATAWBA VALLEY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Pamela Gallagher
Title
VP of Finance/Cfo
Phone
(828) 326-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

137 Island Ford Rd
Maiden, NC 28650-8735

Mailing address

137 Island Ford Rd
Maiden, NC 28650-8735
Phone (828) 732-5000

Other identifiers 2

IdentifierTypeStateIssuer
026CWOtherNCNC BCBS
1124305792MedicaidNC

Other names 1

  • CATAWBA VALLEY FAMILY MEDICINE - MAIDEN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120420000030 NC Part B Supplier - Clinic/Group Practice 6305007279 Receives reassigned benefits from 162 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hickory, NC; Lenoir, NC; Maiden, NC; Newton, NC; Sherrills Ford, NC; Sherrills FRD, NC; Taylorsville, NC; Claremont, NC…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory
Tax ID family
Catawba Valley Medical Groupinc23 organizations share this tax ID, including this one
Part of
Catawba Valley Medical C

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1124305792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 ISLAND FORD RD",
            "city": "MAIDEN",
            "state": "NC",
            "postal_code": "286508735",
            "telephone_number": "828-732-5000",
            "fax_number": "828-732-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 ISLAND FORD RD",
            "city": "MAIDEN",
            "state": "NC",
            "postal_code": "286508735",
            "telephone_number": "828-732-5000",
            "fax_number": "828-732-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATAWBA VALLEY MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATAWBA VALLEY MEDICAL CENTER",
        "enumeration_date": "2011-11-10",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "VP OF FINANCE/CFO",
        "authorized_official_telephone_number": "828-326-3800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BCBS",
            "identifier": "026CW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124305792",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CATAWBA VALLEY FAMILY MEDICINE - MAIDEN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CATAWBA VALLEY FAMILY MEDICINE - MAIDEN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maiden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.