NPIMap

Organization Active NPI

Carolinas Medical Center

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Charlotte, NC
National Provider Identifier
1295033157
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
CAROLINAS MEDICAL CENTER
Practice address
101 East W.T. Harris Blvd
Suite 2223
Charlotte, NC 28262-3529
Phone
(704) 512-4400
Fax
(704) 512-4401
NPI assigned
Mar 2, 2011
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Mr. Thomas Ford Laymon
Title
SVP
Phone
(704) 631-0002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P0004X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X Primary

Addresses

Primary practice location

101 East W.T. Harris Blvd
Suite 2223
Charlotte, NC 28262-3529

Mailing address

PO Box 601372
Charlotte, NC 28260-1372
Phone (704) 512-4400

Other identifiers 2

IdentifierTypeStateIssuer
5903972MedicaidNC
NPB197MedicaidSC

Other names 1

  • Carolinas Back and Sports Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ctr for Mental Health69 organizations share this tax ID, including this one
Part of
Ctr for Mental Health

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

101 E Wt Harris Blvd
Ste 2223
Charlotte, NC 28262
Phone (704) 512-4400

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1295033157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601372",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601372",
            "telephone_number": "704-512-4400",
            "fax_number": "704-512-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EAST W.T. HARRIS BLVD",
            "address_2": "SUITE 2223",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623529",
            "telephone_number": "704-512-4400",
            "fax_number": "704-512-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS MEDICAL CENTER",
        "enumeration_date": "2011-03-02",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "704-631-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903972",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB197",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Back and Sports Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 10, 2016; 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.