Caromont Medical Group Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

CAROMONT MEDICAL GROUP INC

Doing business as

Ashley Women's Center

Practice address

1225 E Garrison Blvd
Gastonia, NC 28054-5115

Phone

(704) 865-7416

Fax

(704) 865-7232

NPI assigned

Apr 11, 2011

Last updated

Mar 28, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CAROMONT MEDICAL GROUP INCAs reported in NPPES

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

Authorized official

Name

Randall L. Kelley

Title

President, Ceo

Phone

(704) 834-2133

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ashley Women's Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Caromont Medical Group Inc

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.

• Shaheen Khan, M.D.

  • Internal Medicine Physician
  • Morganton, NC
  • NPI 1013939446
  NPD
• Coltedra SH'Nee Smith, FNP-BC

  • Family Nurse Practitioner
  • Gastonia, NC
  • NPI 1336498732
  NPD
• Thu Thuy T Vu, AGACNP

  • Acute Care Nurse Practitioner
  • Gastonia, NC
  • NPI 1104490630
  NPD

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1679863732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545115",
            "telephone_number": "704-865-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545115",
            "telephone_number": "704-865-7416",
            "fax_number": "704-865-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROMONT MEDICAL GROUP INC",
        "enumeration_date": "2011-04-11",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "704-834-2133"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917946",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashley Women's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caromont Medical Group Inc (CaroMont Orthopedic & Sports Medicine Center)
• Caromont Medical Group Inc (CaroMont Family Medicine)
• Caromont Medical Group Inc (CaroMont Psychiatric Associates)
• Caromont Medical Group Inc (CaroMont Neurosurgery)
• Caromont Medical Group Inc (Carolina Cardiovascular and Thoracic Surgery Associates)
• Caromont Medical Group Inc (CaroMont Urgent Care)
• Caromont Medical Group Inc (CaroMont Neurology)
• Caromont Medical Group Inc (Atrium Women's Specialist)
• Caromont Medical Group Inc (Carolina Surgery)
• Caromont Medical Group Inc (Carolina Heart Specialists)

• Obstetrics & Gynecology Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.