Individual provider Active NPI

Laura Kathleen Altom, M.D.

  • Colon & Rectal Surgery Physician
  • Raleigh, NC
National Provider Identifier
1144481409
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
2016-00654 Issued in NC
Practice address
2800 Blue Ridge Rd Ste 300
Raleigh, NC 27607-6476
Phone
(919) 784-7874
Fax
(919) 784-2708
NPI assigned
Jun 19, 2008
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD.208045 LA
Surgery Physician 208600000X MD.208045 LA
Colon & Rectal Surgery Physician 208C00000X 2016-00654 NC Primary

Addresses

Primary practice location

2800 Blue Ridge Rd Ste 300
Raleigh, NC 27607-6476

Mailing address

2800 Blue Ridge Rd Ste 300
Raleigh, NC 27607-6476
Phone (919) 784-7874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161024001041 NC Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 3870738115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Vanderbilt University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

2800 Blue Ridge Rd
Suite 300
Raleigh, NC 27607-6476
Phone (919) 784-7874

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-00654NCMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

1505 SW Cary Pkwy
Ste 302
Cary, NC 27511
Phone (919) 367-2580

781 Avent Ferry Rd
Ste 214
Holly Springs, NC 27540
Phone (919) 567-6133

850 S Main St
Holly Springs, NC 27540
Phone (919) 784-7093

11200 Governor Manly Way
Ste 208
Raleigh, NC 27614

2800 Blue Ridge Rd
Ste 300
Raleigh, NC 27607
Phone (919) 784-7810

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • Direct secure messaging: laltom180952@direct.unc.nchie.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1144481409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076476",
            "telephone_number": "919-784-7874",
            "fax_number": "919-784-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076476",
            "telephone_number": "919-784-7874",
            "fax_number": "919-784-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTOM",
        "first_name": "LAURA",
        "middle_name": "KATHLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "MD.208045",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "MD.208045",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "2016-00654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.