Carolina Physician Care PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CAROLINA PHYSICIAN CARE PLLC

Practice address

201 E Grover St
Shelby, NC 28150-3917

Phone

(704) 472-8789

Fax

(828) 891-4069

NPI assigned

Jan 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Johnson H Kelly, MD

Title

Owner

Phone

(704) 472-8789

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1669778403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1689",
            "city": "ETOWAH",
            "state": "NC",
            "postal_code": "287291689",
            "telephone_number": "828-891-5524",
            "fax_number": "828-891-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "704-472-8789",
            "fax_number": "828-891-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PHYSICIAN CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-472-8789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carolina Pain Care PC
• Carolina Pulmonary and Comprehensive Sleep Center
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• Carolinas Medical Center at Home, LLC
• Carolinas Medical Center at Home, LLC

• General Practice Physician in Shelby, NC
• Providers in Shelby, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.