The Charlotte-Mecklenburg Hospital Authority

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Doing business as

Cleveland Pines

Practice address

1404 N Lafayette St
Shelby, NC 28150-3406

Phone

(980) 487-7439

Fax

(980) 487-7416

NPI assigned

Nov 6, 2014

Last updated

Nov 24, 2014By 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

Greg A Gombar

Title

Executive VP/Cfo

Phone

(704) 355-2154

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cleveland Pines Doing business as

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1538565338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "980-487-7439",
            "fax_number": "980-487-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 N LAFAYETTE ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "980-487-7439",
            "fax_number": "980-487-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "GOMBAR",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "704-355-2154"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405282",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Pines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lane Cassidy Tesseneer, LCSW
• Tsimmeng Justin Thao, DO
• The Avalib Care Cart, PLLC
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cleveland)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cleveland)
• The Charlotte-Mecklenburg Hospital Authority (Levine Cancer Institute)
• The Charlotte-Mecklenburg Hospital Authority (Carolinas HealthCare System Cleveland)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cleveland)
• The Creek Consulting
• The Kid Guru, LLC

• Skilled Nursing Facility in Shelby, NC
• Providers in Shelby, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.