NPIMap

Organization Active NPI

Carolina Healthcare Associates, Inc.

  • Urology Physician
  • Leland, NC
National Provider Identifier
1467680587
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CAROLINA HEALTHCARE ASSOCIATES, INC.
Practice address
1333 S Dickinson Dr
Suite 230
Leland, NC 28451-6430
Phone
(910) 254-1033
Fax
(910) 343-0171
NPI assigned
Jun 26, 2009
Organization subpart
Yes
Parent organization
CAROLINA HEALTHCARE ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Authorized official

Name
Mr. Daniel Eugene Goodwin
Title
Vice President
Phone
(910) 667-7597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1333 S Dickinson Dr
Suite 230
Leland, NC 28451-6430

Mailing address

PO Box 602484
Charlotte, NC 28260-2484
Phone (910) 254-1033

Other identifiers 2

IdentifierTypeStateIssuer
1467680587MedicaidNC
5916302MedicaidNC

Other names 1

  • Urology Comprehensive Services Doing business as

National Provider Directory

National Provider Directory
Part of
Carolina Healthcare Assoc

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1467680587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602484",
            "telephone_number": "910-254-1033",
            "fax_number": "910-343-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S DICKINSON DR",
            "address_2": "SUITE 230",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516430",
            "telephone_number": "910-254-1033",
            "fax_number": "910-343-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTHCARE ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA HEALTHCARE ASSOCIATES, INC.",
        "enumeration_date": "2009-06-26",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "910-667-7597",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467680587",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916302",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology Comprehensive Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.