NPIMap

Organization Active NPI

Cleco Primary Care Network

Doing business as Cherryville Family Care

  • Family Medicine Physician
  • Cherryville, NC
National Provider Identifier
1295715647
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLECO PRIMARY CARE NETWORK
Doing business as
Cherryville Family Care
Practice address
600 W Church St
Cherryville, NC 28021-2863
Phone
(704) 435-4111
Fax
(704) 435-4113
NPI assigned
Jan 20, 2006
Last updated
Aug 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Denise Rollins Cooper
Title
Executive Director
Phone
(704) 484-3647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

600 W Church St
Cherryville, NC 28021-2863

Mailing address

101 Grover St
Shelby, NC 28150
Phone (704) 484-3647

Other identifiers 1

IdentifierTypeStateIssuer
890159QMedicaidNC

Other names 1

  • CHERRYVILLE FAMILY CARE Doing business as

National Provider Directory

National Provider Directory

Locations

600 W Church St
Cherryville, NC 28021
Phone (704) 435-4111

101 E Grover St
Shelby, NC 28150
Phone (704) 480-9344

Practitioners & affiliated clinicians

Practitioners 9

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": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1295715647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "704-484-3647",
            "fax_number": "704-471-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W CHURCH ST",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280212863",
            "telephone_number": "704-435-4111",
            "fax_number": "704-435-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLECO PRIMARY CARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "ROLLINS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-484-3647"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890159Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHERRYVILLE FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherryville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.