Carolina Cardiology, Sleep & Obesity Center PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CAROLINA CARDIOLOGY, SLEEP & OBESITY CENTER PC

Practice address

3280 Henderson Dr Ste C
Jacksonville, NC 28546-5290

Phone

(910) 915-8450

NPI assigned

Nov 12, 2013

Last updated

Sep 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shyamal Kishore Mitra, M.D.NPI 1467437079

Title

Owner

Phone

(252) 525-3290

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

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.

• Shyamal K Mitra, MD

  • Cardiovascular Disease Physician
  • Jacksonville, NC
  • NPI 1467437079
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanie Marie Place, FNP

  • Nurse Practitioner
  • Jacksonville, NC
  • NPI 1366917999
  Medicare reassignment Care Compare group NPD
• Anne Marie Growney, PA-C

  • Physician Assistant
  • Sneads Ferry, NC
  • NPI 1457897282
  Medicare reassignment Care Compare group
• Michelle L Snyder, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1053021717
  Medicare reassignment NPD

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1518397587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465290",
            "telephone_number": "910-915-8450",
            "fax_number": "888-745-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 HENDERSON DR STE C",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465290",
            "telephone_number": "910-915-8450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1136 Hwy 258 N Ste 102",
            "address_purpose": "LOCATION",
            "city": "Kinston",
            "state": "NC",
            "postal_code": "285048304",
            "country_code": "US",
            "telephone_number": "910-915-8450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINA CARDIOLOGY, SLEEP & OBESITY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "MITRA",
        "authorized_official_first_name": "SHYAMAL",
        "authorized_official_middle_name": "KISHORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-525-3290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "00-35439",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NC",
            "license": "00-35439",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NC",
            "license": "00-35439",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carenet, Inc. (Baptist Hospital CareNet Counseling Centers)
• Carl R Kriebel, DMD, PA (Absolutely Dental)
• Katie John E Carnelley
• Roderic Griffin Carney, MD
• Carolina Autism Institute-ABA, Inc.
• Carolina Coast Lactation, LLC (Carolina Coast Lactation)
• Carolina Healthcare Associates Inc (Onslow Oncology)
• Carolina Home Medical, Inc.
• Carolina Homecare Group, LLC (First Day Homecare #025)
• Carolina Orthopedic and Sports Medicine, Inc.

• Internal Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.