NPIMap

Organization Active NPI

Carolinas Medical Center

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Matthews, NC
National Provider Identifier
1346547809
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
332 Sam Newell Rd
Suite 1200
Matthews, NC 28105-6566
Phone
(704) 512-4400
Fax
(704) 512-4401
NPI assigned
Feb 18, 2011
Organization subpart
Yes
Parent organization
CAROLINAS MEDICAL CENTERAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. Thomas Ford Laymon
Title
Senior Vice President
Phone
(704) 631-0002

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Ctr for Mental Health (69 organizations share this tax ID)
Part of
Ctr for Mental Health

Locations

332 Sam Newell Rd
Ste 1200
Matthews, NC 28105
Phone (704) 512-4400

Specialties & licenses 2

NPPES NPI Registry
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

NPPES NPI Registry

Primary practice location

332 Sam Newell Rd
Suite 1200
Matthews, NC 28105-6566

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
5903972MedicaidNC
NPB197MedicaidSC

Other names 1

NPPES NPI Registry
  • Carolinas Bank and Sports Specialists Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2016.

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1346547809",
    "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": "332 SAM NEWELL RD",
            "address_2": "SUITE 1200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056566",
            "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": "2011-02-18",
        "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": "SENIOR VICE PRESIDENT",
        "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 Bank and Sports Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matthews, 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.