Organization Active NPI

NCGM Inc

  • Clinical Medical Laboratory
  • Apex, NC
National Provider Identifier
1508453739
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Aug 14, 2023

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20210203000587 NC Part B Supplier - Independent Clinical Laboratory 3274947254 Practice locations: Apex, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2205781NCGM, Inc9760 Holly Springs Road, Apex, NC 27539AccreditationSep 23, 2027

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.