Active NPI
NCGM Inc
- Clinical Medical Laboratory
- Apex, NC
National Provider Identifier
1508453739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- NCGM INC
- Practice address
- 9760 Holly Springs Rd
Apex, NC 27539-7620 - Phone
- (919) 267-4688
- NPI assigned
- Dec 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Shailesh Vyas
- Title
- Chief Finance Officer
- Phone
- (919) 267-4688
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
9760 Holly Springs Rd
Apex, NC 27539-7620
Mailing address
9760 Holly Springs Rd
Apex, NC 27539-7620
Phone (919) 267-4688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210203000587 | NC | Part B Supplier - Independent Clinical Laboratory | 3274947254 | Practice locations: Apex, NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2205781 | NCGM, Inc | Accreditation | Sep 23, 2027 |
National Provider Directory
National Provider DirectoryLocations
9760 Holly Springs Rd
Apex, NC 27539
Phone (919) 267-4688
840 Main Campus Dr
Ste 3570
Raleigh, NC 27606
Phone (978) 821-6172
840 Main Campus Dr
Raleigh, NC 27606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691971200000",
"number": "1508453739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9760 HOLLY SPRINGS RD",
"city": "APEX",
"state": "NC",
"postal_code": "275397620",
"telephone_number": "919-267-4688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9760 HOLLY SPRINGS RD",
"city": "APEX",
"state": "NC",
"postal_code": "275397620",
"telephone_number": "919-267-4688"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NCGM INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-22",
"last_updated": "2023-08-14",
"certification_date": "2020-12-22",
"status": "A",
"authorized_official_last_name": "VYAS",
"authorized_official_first_name": "SHAILESH",
"authorized_official_title_or_position": "CHIEF FINANCE OFFICER",
"authorized_official_telephone_number": "919-267-4688",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apex, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.