Polyclinic Medical Center, Inc.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

2000-01378 Issued in NC

Legal business name

POLYCLINIC MEDICAL CENTER, INC.

Practice address

9705 Northeast Pkwy Ste 400
Matthews, NC 28105-9704

Phone

(704) 844-8971

Fax

(704) 844-8972

NPI assigned

Mar 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Josi Braz Garuba

Title

Ceo

Phone

(704) 844-8971

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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

• Abdul Karim Garuba, MD

  • Internal Medicine Physician
  • Matthews, NC
  • NPI 1063483113

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Sanam Khand Thakuri, FNP

  • Family Nurse Practitioner
  • Matthews, NC
  • NPI 1548014384
  Medicare reassignment Care Compare group NPD
• Ha Thi Ngoc Nguyen

  • Psychiatric/Mental Health Nurse Practitioner
  • Huntersville, NC
  • NPI 1861961518
  NPD (past)
• Rolande C. Romain, M.D

  • Pediatrics Physician
  • Matthews, NC
  • NPI 1679532055
  NPD (past)
• Kathryn Emily Stoodt, FNP-BC

  • Family Nurse Practitioner
  • Gastonia, NC
  • NPI 1740891423
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1821059650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9705 NORTHEAST PKWY STE 400",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059704",
            "telephone_number": "704-844-8971",
            "fax_number": "704-844-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9705 NORTHEAST PKWY STE 400",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281059704",
            "telephone_number": "704-844-8971",
            "fax_number": "704-844-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLYCLINIC MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "GARUBA",
        "authorized_official_first_name": "JOSI",
        "authorized_official_middle_name": "BRAZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-844-8971",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2000-01378",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "25646",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903156",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean Pitale, O.D.
• Kathryn Plemmons
• Carly Plotkin, MA CCC-SLP
• Steven R. Plunkett, M.D.
• Polaris Health, PA
• Joseph Daniel Pope, MS, LCMHC, LCAS
• Amexia Markeitta Harris Porterfield
• Sarah Kaitlyn Post
• Anita Powell, PHARMD
• Carolyn Kelly Powell, MA LCMHCA

• Critical Care Medicine (Internal Medicine) Physician in Matthews, NC
• Providers in Matthews, NC by specialty
• Critical Care Medicine (Internal Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.