Organization Active NPI

Calvary Community Medical Clinic

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1356222483
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CALVARY COMMUNITY MEDICAL CLINIC
Practice address
537 W Sugar Creek Rd Ste 201
Charlotte, NC 28213-6103
Phone
(704) 979-8210
Fax
(877) 492-8881
NPI assigned
Sep 8, 2025
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Mr. Okyere Bonna
Title
Administator
Phone
(704) 526-9052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

537 W Sugar Creek Rd Ste 201
Charlotte, NC 28213-6103

Mailing address

537 W Sugar Creek Rd Ste 201
Charlotte, NC 28213-6103
Phone (704) 979-8210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250915001954 NC Part B Supplier - Clinic/Group Practice 5193228096 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

537 W Sugar Creek Rd
Ste 201
Charlotte, NC 28213
Phone (704) 979-8210

Practitioners & affiliated clinicians

Practitioners 1

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": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1356222483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 W SUGAR CREEK RD STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136103",
            "telephone_number": "704-979-8210",
            "fax_number": "877-492-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W SUGAR CREEK RD STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136103",
            "telephone_number": "704-979-8210",
            "fax_number": "877-492-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVARY COMMUNITY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "BONNA",
        "authorized_official_first_name": "OKYERE",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "704-526-9052",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.