NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc.

Doing business as Hallmark Family Physicians

  • Family Medicine Physician
  • Lenoir, NC
National Provider Identifier
1144402157
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC.
Doing business as
Hallmark Family Physicians
Practice address
1766 Connelly Springs Road
Lenoir, NC 28645-7827
Phone
(828) 728-8224
Fax
(828) 728-1690
NPI assigned
Nov 30, 2007
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
CALDWELL MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Donald F Gardner Jr.
Title
VP/Cfo/Cco
Phone
(828) 757-5221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1766 Connelly Springs Road
Lenoir, NC 28645-7827

Mailing address

PO Box 710
Lenoir, NC 28645-0710
Phone (828) 757-5070

Other identifiers 3

IdentifierTypeStateIssuer
019R9OtherNCBCBS
5908592MedicaidNC
DF3472OtherNCRR MEDICARE

Other names 1

  • Hallmark Family Physicians Doing business as

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

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Part of
Caldwell Memorial Hosp Inc

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1144402157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286450710",
            "telephone_number": "828-757-5070",
            "fax_number": "828-757-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1766 CONNELLY SPRINGS ROAD",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286457827",
            "telephone_number": "828-728-8224",
            "fax_number": "828-728-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2007-11-30",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP/CFO/CCO",
        "authorized_official_telephone_number": "828-757-5221",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019R9",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908592",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF3472",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hallmark Family Physicians",
            "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 Jul 17, 2013; 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.