NPIMap

Organization Active NPI

Caromont Medical Group Inc

Doing business as Atrium Women's Specialist

  • Obstetrics & Gynecology Physician
  • Gastonia, NC
National Provider Identifier
1750560405
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CAROMONT MEDICAL GROUP INC
Doing business as
Atrium Women's Specialist
Practice address
2544 Court Dr
Ste a
Gastonia, NC 28054-3450
Phone
(704) 865-9509
Fax
(704) 671-7482
NPI assigned
Oct 30, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Wayne F Shovelin
Title
President, Ceo
Phone
(704) 834-2133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

2544 Court Dr
Ste a
Gastonia, NC 28054-3450

Mailing address

2544 Court Dr
Ste a
Gastonia, NC 28054-3450
Phone (704) 865-9509

Other identifiers 1

IdentifierTypeStateIssuer
89016R3MedicaidNC

Other names 1

  • Atrium Women's Specialist Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000070 NC Part B Supplier - Clinic/Group Practice 3577476258 Receives reassigned benefits from 760 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Kings Mountain, NC; Lenoir, NC; McAdenville, NC; Morganton, NC; Shelby, NC; Stanley, NC; Belmont, NC…

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1750560405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 COURT DR",
            "address_2": "STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-865-9509",
            "fax_number": "704-671-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR",
            "address_2": "STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-865-9509",
            "fax_number": "704-671-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "SHOVELIN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "F",
        "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": "89016R3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atrium Women's Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.