Caromont Health Services, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CAROMONT HEALTH SERVICES, INC.

Doing business as

CaroMont Endoscopy Center

Practice address

1212 Spruce St
Belmont, NC 28012-3385

Phone

(704) 825-5677

Fax

(704) 825-1197

NPI assigned

Sep 2, 2011

Last updated

Sep 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Douglas R Luckett

Title

Acting Ceo

Phone

(704) 834-3684

Specialties & licenses 1

Addresses

Other names 1

• CaroMont Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Caromont Health Services, Inc.

  dba CaroMont Specialty Surgery

  • Ambulatory Surgical Clinic/Center
  • Gastonia, NC
  • NPI 1902895675

  O20050114000100

  Same enrollment

Listed as

Cec Dba Belmont EndoCCN 34C0001182

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Caromont Specialty Surgery5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Caromont Health Services Inc.

  dba Courtland Terrace

  • Skilled Nursing Facility
  • Gastonia, NC
  • NPI 1073599510
  NPD tax ID
• Caromont Health Services, Inc.

  dba CaroMont Health Ambulatory Imaging Center

  • Radiology Clinic/Center
  • Belmont, NC
  • NPI 1356263313
  NPD tax ID
• Caromont Health Services, Inc.

  dba CaroMont Specialty Surgery

  • Ambulatory Surgical Clinic/Center
  • Gastonia, NC
  • NPI 1902895675
  NPD tax ID
• Caromont Health Services, Inc.

  dba CaroMont Health Mobile Imaging

  • Mobile Radiology Clinic/Center
  • Gastonia, NC
  • NPI 1982526935
  NPD tax ID

Locations

Practitioners 1

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.

• Crystal Cornelia Maddox, M.D.

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1942520937
  NPD (past)

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1790066876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1747",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280531747",
            "telephone_number": "704-834-2155",
            "fax_number": "704-834-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 SPRUCE ST",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280123385",
            "telephone_number": "704-825-5677",
            "fax_number": "704-825-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ACTING CEO",
        "authorized_official_telephone_number": "704-834-3684",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CaroMont Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolinas Counseling & Consulting, LLC (james t hartness)
• Carolinas Physicians Network Inc (Atrium Health Urgent Care)
• Carolinas Physicians Network Inc (Carolinas Hospitalist Group - Carolina Rehab - Mt. Holly)
• Carolinas Physicians Network, Inc
• Caromont Health Services, Inc. (CaroMont Health Ambulatory Imaging Center)
• Caromont Medical Group Inc (CaroMont Physical Therapy)
• Caromont Medical Group Inc (Arthritis Associates)
• Caromont Medical Group Inc (CaroMont Integrated Pain Specialists-Belmont)
• Caromont Medical Group Inc (CaroMont Pediatric Partners)
• Caromont Medical Group, Inc. (South Point Family Practice)

• Ambulatory Surgical Clinic/Center in Belmont, NC
• Providers in Belmont, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.