Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Charles Crumley MD

  • Internal Medicine Physician
  • Lincolnton, NC
National Provider Identifier
1639108533
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Charles Crumley MD
Practice address
751 S Laurel St
Lincolnton, NC 28092-3622
Phone
(704) 735-3081
Fax
(704) 735-1083
NPI assigned
Jul 2, 2006
Last updated
Sep 25, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Daniel L Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

751 S Laurel St
Lincolnton, NC 28092-3622

Mailing address

PO Box 601400
Charlotte, NC 28260-1400
Phone (704) 735-3801

Other identifiers 1

IdentifierTypeStateIssuer
891133YMedicaidNC

Other names 1

  • Charles Crumley MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000455 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 1,949 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Diabetes Endocrine Osteopo

Locations

751 S Laurel St
Lincolnton, NC 28092
Phone (704) 735-3081

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1639108533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601400",
            "telephone_number": "704-735-3801",
            "fax_number": "704-735-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S LAUREL ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923622",
            "telephone_number": "704-735-3081",
            "fax_number": "704-735-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK  INC",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891133Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles Crumley MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.