Organization Active NPI

Cleveland Gastroenterology Associates, P.a.

  • Gastroenterology Physician
  • Shelby, NC
National Provider Identifier
1518938240
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CLEVELAND GASTROENTEROLOGY ASSOCIATES, P.A.
Practice address
808 N Washington St
Shelby, NC 28150-3858
Phone
(704) 480-0008
Fax
(704) 480-0010
NPI assigned
Jan 31, 2006
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Miss Elizabeth Glover
Title
Office Manager
Phone
(704) 480-0008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

808 N Washington St
Shelby, NC 28150-3858

Mailing address

808 N Washington St
Shelby, NC 28150-3858
Phone (704) 480-0008

Other identifiers 1

IdentifierTypeStateIssuer
890140GMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1518938240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N WASHINGTON ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503858",
            "telephone_number": "704-480-0008",
            "fax_number": "704-480-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N WASHINGTON ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503858",
            "telephone_number": "704-480-0008",
            "fax_number": "704-480-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND GASTROENTEROLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "704-480-0008",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890140G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.