Carolina Medicorp Enterprises Inc
Organization Active NPI Family Medicine Physician · Thomasville, NC
NPI 1295170207 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1295170207
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CAROLINA MEDICORP ENTERPRISES INC
- Practice address
- 1122 Randolph St
Thomasville, NC 27360-5175 - Phone
- (336) 474-3433
- Fax
- (336) 474-1052
- NPI assigned
- May 3, 2013
- Organization subpart
- No
Authorized official
- Name
- Geoffrey K Gardner
- Title
- VP NMG Finance
- Phone
- (704) 384-7605
Other NPIs on the same Medicare enrollment 32
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040110000190 | NC | Part B Supplier - Clinic/Group Practice | 0648174904 |
Receives reassigned benefits from 249 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cornelius, NC; Greensboro, NC; High Point, NC; Huntersville, NC; Indian Trail, NC; Kernersville, NC; Lexington, NC; Matthews, NC… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1122 Randolph St
Thomasville, NC 27360-5175
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 474-3433
Other names
- Novant Health Express Care
Other providers in Thomasville, NC
- Leanne Johnson Cantrell
- Caremedicalcenterpllc
- Carenet, Inc.
- Keirah Carmichael
- Carolina Home Advantage, LLC
- Carolina Regional Heart Center, LLC
- Case Management Connection of the Triad, Inc.
- Cassandra Loeffler PLLC
- Ronnie Dean Casterlow
- Bradley Cecil
All providers in Thomasville, NC · Family Medicine 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 Jul 15, 2015. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.