Caldwell Memorial Hospital, Inc
Organization Active NPI Obstetrics & Gynecology Physician · Lenoir, NC
NPI 1174882344 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1174882344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- CALDWELL MEMORIAL HOSPITAL, INC
- Practice address
- 906 College Ave SW
Suite a
Lenoir, NC 28645-5428 - Phone
- (828) 757-3301
- Fax
- (828) 757-3254
- NPI assigned
- May 9, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- CALDWELL MEMORIAL HOSPITAL, INC
Authorized official
- Name
- Karen Shadowens
- Title
- Cfo
- Phone
- (828) 757-5100
Other NPIs on the same Medicare enrollment 26
Practitioners 18
-
Amy Abouzied, MD
-
Sally Mae Baird, NP-C
-
Susanna Joy Calhoun, RDN, LDN
-
Amanda Goble Franks, LCSW
-
Wendy Johnston Hartsoe, FNP-C
-
Richelle C Miller, FNP
-
Jennifer Perry, RD, LDN, CDE
-
Robert J Reichling, M.D.
-
Jordan Logan Simpson, M.D.
-
Darla Rae Stevens, FNP-C
-
Laurie K Toman, FNP
-
Daniel Waksman, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0883650 | Laurel Park Women'S Health | Provider-performed microscopy | Sep 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Caldwell Mem Hosp
Locations
4355 Hickory Blvd
Ste 1
Granite Falls, NC 28630
Phone (828) 757-8251
906 College Ave SW
Ste A
Lenoir, NC 28645
Phone (828) 757-3301
906 College Ave SW
Ste B
Lenoir, NC 28645
Phone (828) 757-5502
907 College Ave SW Ste a
Lenoir, NC 28645
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
906 College Ave SW
Suite a
Lenoir, NC 28645-5428
Mailing address
906 College Ave SW
Suite a
Lenoir, NC 28645-5428
Phone (828) 757-3301
Other names
- Laurel Park Women's Health
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Lenoir, NC
- Caldwell Memorial Hospital Inc
- Caldwell Memorial Hospital Inc
- Caldwell Memorial Hospital Inc.
- Caldwell Memorial Hospital Inc.
- Caldwell Memorial Hospital, Inc
- Caldwell Memorial Hospital, Inc
- Caldwell Memorial Hospital, Inc
- Caldwell Memorial Hospital, Inc
- Caldwell Memorial Hospital, Inc
- Caldwell Memorial Hospital, Inc
All providers in Lenoir, NC · Obstetrics & Gynecology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.