NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc.

  • Gastroenterology Physician
  • Hickory, NC
National Provider Identifier
1831965201
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC.
Practice address
36 14TH Ave NE Ste 2B
Hickory, NC 28601-2580
Phone
(828) 757-6275
NPI assigned
Nov 28, 2023
Organization subpart
Yes
Parent organization
CALDWELL MEMORIAL HOSPITAL, INC.As reported in NPPES

Authorized official

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

Other NPIs with the same Medicare PAC ID 12

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

Practitioners 219

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

View all 219

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2293980Digestive Health Center Hickory Plus Urgent36 14TH Avenue NE, Hickory, NC 28601Certificate of waiverNov 16, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240402000752 NC Part B Supplier - Clinic/Group Practice 5395646970 Receives reassigned benefits from 8 practitioners
Practice locations: Hickory, NC

National Provider Directory

National Provider Directory
Tax ID family
Caldwell Mem Hosp26 organizations share this tax ID, including this one
Part of
Caldwell Mem Hosp

Other organizations with this tax ID 25

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

View all 25

Locations

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

NPPES NPI Registry

Primary practice location

36 14TH Ave NE Ste 2B
Hickory, NC 28601-2580

Mailing address

321 Mulberry St SW
Lenoir, NC 28645-5720
Phone (182) 875-7510

Other names 1

NPPES NPI Registry
  • Digestive Health Center Hickory Doing business as

Electronic endpoints 1

NPPES NPI Registry
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 format, last updated by the provider on Jan 21, 2025.

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1831965201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "182-875-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 14TH AVE NE STE 2B",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012580",
            "telephone_number": "828-757-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2023-11-28",
        "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": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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": [
        {
            "organization_name": "Digestive Health Center Hickory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Digestive Health Center Hickory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.