NPIMap

Organization Active NPI

Caromont Medical Group Inc

Doing business as CaroMont Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Gastonia, NC
National Provider Identifier
1457913006
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CAROMONT MEDICAL GROUP INC
Doing business as
CaroMont Foot and Ankle
Practice address
2391 Court Dr Ste 100
Gastonia, NC 28054-2197
Phone
(980) 834-7300
Fax
(980) 834-9874
NPI assigned
Jul 3, 2019
Last updated
Aug 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROMONT MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
David Michael Oconnor
Title
Cfo
Phone
(704) 671-5343

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

2391 Court Dr Ste 100
Gastonia, NC 28054-2197

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other identifiers 2

IdentifierTypeStateIssuer
1457913006MedicaidNC
02G2BOtherNCBCBS OF NC

Other names 2

  • CaroMont Foot and Ankle Doing business as
  • CaroMont Podiatry Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000070 NC Part B Supplier - Clinic/Group Practice 3577476258 Receives reassigned benefits from 760 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Kings Mountain, NC; Lenoir, NC; McAdenville, NC; Morganton, NC; Shelby, NC; Stanley, NC; Belmont, NC…

National Provider Directory

National Provider Directory
Part of
Caromont Medical Group in

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1457913006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 COURT DR STE 100",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542197",
            "telephone_number": "980-834-7300",
            "fax_number": "980-834-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROMONT MEDICAL GROUP INC",
        "enumeration_date": "2019-07-03",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-671-5343"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457913006",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "02G2B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CaroMont Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CaroMont Podiatry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.