NPIMap

Organization Active NPI

The Charlotte-Mecklenburg Hospital Authority

Doing business as Carolinas HealthCare System Cleveland

  • Certified Registered Nurse Anesthetist
  • Shelby, NC
National Provider Identifier
1700283603
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Doing business as
Carolinas HealthCare System Cleveland
Practice address
201 E Grover St
Shelby, NC 28150-3917
Phone
(980) 487-7427
NPI assigned
Nov 21, 2014
Last updated
Nov 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
Mr. Greg Gombar
Title
Administrator
Phone
(704) 355-2154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

201 E Grover St
Shelby, NC 28150-3917

Mailing address

PO Box 32861
Charlotte, NC 28232-2861
Phone (704) 512-7124

Other names 1

  • Carolinas HealthCare System Cleveland Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100309000605 NC Part B Supplier - Clinic/Group Practice 2961310685 Receives reassigned benefits from 1,831 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Medical Center104 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

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1700283603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32861",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282322861",
            "telephone_number": "704-512-7124"
        },
        {
            "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": "980-487-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "GOMBAR",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-355-2154",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas HealthCare System Cleveland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.