NPIMap

Organization Active NPI

Providence Urology, PLLC

  • Urology Physician
  • Monroe, NC
National Provider Identifier
1255537403
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
200000981 Issued in NC
Legal business name
PROVIDENCE UROLOGY, PLLC
Practice address
1428 Ellen St
Suite a
Monroe, NC 28112-5285
Phone
(704) 289-4361
Fax
(704) 283-4705
NPI assigned
Jun 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Arthur J. Lim, M.D.NPI 1912926668
Title
Physician/Co-Owner
Phone
(704) 289-4361

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X NC
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X 200000981 NC Primary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X 200101464 NC

Addresses

Primary practice location

1428 Ellen St
Suite a
Monroe, NC 28112-5285

Mailing address

1428 Ellen St
Suite a
Monroe, NC 28112-5285
Phone (704) 289-4361

National Provider Directory

National Provider Directory

Locations

1428 Ellen St
Ste A
Monroe, NC 28112
Phone (704) 226-0605

3614 S Providence Rd
Ste 100
Waxhaw, NC 28173
Phone (704) 289-4361

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1255537403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 ELLEN ST",
            "address_2": "SUITE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125285",
            "telephone_number": "704-289-4361",
            "fax_number": "704-283-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 ELLEN ST",
            "address_2": "SUITE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125285",
            "telephone_number": "704-289-4361",
            "fax_number": "704-283-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE UROLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN/CO-OWNER",
        "authorized_official_telephone_number": "704-289-4361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "200000981",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "200101464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.