NPIMap

Caldwell Memorial Hospital, Inc.

Organization Active NPI General Acute Care Hospital · Lenoir, NC

NPI 1740312552 · NPPES record last updated Jan 21, 2025

Key facts

NPI
1740312552
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
H0074 (NC)
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC.
Practice address
321 Mulberry St SW
Lenoir, NC 28645-1890
Phone
(828) 757-5100
Fax
(828) 757-5937
NPI assigned
Mar 9, 2007
Organization subpart
Yes
Parent organization (as reported)
CALDWELL MEMORIAL HOSPITAL, INC.

Authorized official

Name
Karen Shadowens
Title
Cfo
Phone
(336) 627-8512

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 239

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 239

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040116000355 NC Part B Supplier - Clinic/Group Practice 5395646970 Receives reassigned benefits from 325 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lenoir, NC; Chapel Hill, NC; Blowing Rock, NC; Granite Falls, NC; Hickory, NC; Hudson, NC
O20040219000941 NC Part B Supplier - Clinic/Group Practice 5395646970 Receives reassigned benefits from 40 practitioners
1 other NPI on this enrollment
Practice locations: Lenoir, NC; Granite Falls, NC

National Provider Directory

Part of
Caldwell Mem Hosp

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H0074 NC Yes
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP		 367500000X

Addresses

Primary practice location

321 Mulberry St SW
Lenoir, NC 28645-1890

Mailing address

PO Box 710
Lenoir, NC 28645-0710
Phone (828) 757-5100

Other identifiers

IdentifierTypeStateIssuer
8000224MedicaidNC
00733AOtherNCBCBS

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 21, 2025.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1740312552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286450710",
            "telephone_number": "828-757-5100",
            "fax_number": "828-757-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286451890",
            "telephone_number": "828-757-5100",
            "fax_number": "828-757-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "SHADOWENS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-627-8512"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "H0074",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000224",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00733A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenoir, NC

All providers in Lenoir, NC · General Acute Care Hospital in North Carolina

Sources for this page

Verify at the official NPI Registry.