NPIMap

Organization Active NPI

Cabarrus Gastroenterology Associates, PLLC

Doing business as Northeast Digestive Health Center

  • Gastroenterology Physician
  • Salisbury, NC
National Provider Identifier
1154008142
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLC
Doing business as
Northeast Digestive Health Center
Practice address
510 Corporate Circle
Salisbury, NC 28147
Phone
(704) 783-1840
NPI assigned
Jun 30, 2023
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Taylor A Blackman
Title
Ceo
Phone
(704) 783-1840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

510 Corporate Circle
Salisbury, NC 28147

Mailing address

78 Church St NE
Concord, NC 28025-4757
Phone (704) 783-1840

Other names 1

  • Northeast Digestive Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040113000342 NC Part B Supplier - Clinic/Group Practice 9436059649 Receives reassigned benefits from 65 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Concord, NC; Salisbury, NC

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Cabarrus Gastroenterology4 organizations share this tax ID, including this one
Part of
Cabarrus Gastroenterology

Other organizations with this tax ID 3

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

Locations

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

200 Medical Park Dr
Ste 257
Concord, NC 28025
Phone (704) 783-1840

78 Church St NE
Concord, NC 28025
Phone (980) 219-1809

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1154008142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 CHURCH ST NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254757",
            "telephone_number": "704-783-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CORPORATE CIRCLE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28147",
            "telephone_number": "704-783-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CABARRUS GASTROENTEROLOGY ASSOCIATES, PLLC",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "BLACKMAN",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-783-1840"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Digestive Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.