NPIMap

Organization Active NPI

Carolinas Cancer Care PA

  • Specialist
  • Charlotte, NC
National Provider Identifier
1235126517
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
21568 Issued in NC
Legal business name
CAROLINAS CANCER CARE PA
Practice address
411 Billingsley Rd
Suite 103
Charlotte, NC 28211-1066
Phone
(704) 344-1995
Fax
(704) 344-9125
NPI assigned
Oct 3, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas Wray Hauch, MD
Title
President/Owner
Phone
(704) 344-1995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 21568 NC Primary

Addresses

Primary practice location

411 Billingsley Rd
Suite 103
Charlotte, NC 28211-1066

Mailing address

411 Billingsley Rd
Suite 103
Charlotte, NC 28211-1066
Phone (704) 344-1995

Other identifiers 1

IdentifierTypeStateIssuer
89011V4MedicaidNC

National Provider Directory

National Provider Directory

Locations

1401 Matthews Township Pkwy
Ste 208
Matthews, NC 28105
Phone (704) 321-1002

Practitioners & affiliated clinicians

Practitioners 10

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": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235126517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111066",
            "telephone_number": "704-344-1995",
            "fax_number": "704-344-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111066",
            "telephone_number": "704-344-1995",
            "fax_number": "704-344-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS CANCER CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAUCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WRAY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "704-344-1995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "21568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011V4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.