Organization Active NPI

Carolinas Physicians Network Inc

Doing business as Carolinas Cancer Care

  • Hematology & Oncology Physician
  • Charlotte, NC
National Provider Identifier
1740590074
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CAROLINAS PHYSICIANS NETWORK INC
Doing business as
Carolinas Cancer Care
Practice address
411 Billingsley Rd
Suite 103
Charlotte, NC 28211-1046
Phone
(704) 344-1995
Fax
(704) 344-1705
NPI assigned
Oct 20, 2010
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CAROLINAS PHYSICIANS NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Mr. Thomas Ford Laymon
Title
Senior Vice President
Phone
(704) 631-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

411 Billingsley Rd
Suite 103
Charlotte, NC 28211-1046

Mailing address

PO Box 602148
Charlotte, NC 28260-2148
Phone (704) 344-1995

Other identifiers 1

IdentifierTypeStateIssuer
5916086MedicaidNC

Other names 1

  • Carolinas Cancer Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000819 NC Part B Supplier - Clinic/Group Practice 3375449655 Receives reassigned benefits from 2,518 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Diabetes Endocrine Osteopo

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1740590074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602148",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602148",
            "telephone_number": "704-344-1995",
            "fax_number": "704-344-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111046",
            "telephone_number": "704-344-1995",
            "fax_number": "704-344-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINAS PHYSICIANS NETWORK INC",
        "enumeration_date": "2010-10-20",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-631-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5916086",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Cancer Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.