NPIMap

Organization Active NPI

Healthstat Onsite Clinic Hog Slat Newton Grove

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Newton Grove, NC
National Provider Identifier
1639707227
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
HEALTHSTAT ONSITE CLINIC HOG SLAT NEWTON GROVE
Practice address
412 Clinton St
Newton Grove, NC 28366-8539
Phone
(704) 936-5546
NPI assigned
Mar 30, 2020
Last updated
Mar 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Authorized official

Name
Jill Johnson Patton
Title
Director of Risk Management
Phone
(704) 936-5546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X NU Primary

Addresses

Primary practice location

412 Clinton St
Newton Grove, NC 28366-8539

Mailing address

4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916

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
34D2182051Healthstat Onsite Clinic Hog412 Clinton Street, Newton Grove, NC 28366Certificate of waiverApr 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Healthstat Onsite Clinic Parkdale Plant 16237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1639707227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 CLINTON ST",
            "city": "NEWTON GROVE",
            "state": "NC",
            "postal_code": "283668539",
            "telephone_number": "704-936-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ONSITE CLINIC HOG SLAT NEWTON GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton Grove, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.