NPIMap

Organization Active NPI

The Charlotte-Mecklenburg Hospital Authority

Doing business as Heart Success Clinic

  • Cardiovascular Disease Physician
  • Concord, NC
National Provider Identifier
1841627437
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Doing business as
Heart Success Clinic
Practice address
1090 Northeast Gateway Court NE
Suite 101
Concord, NC 28025-2440
Phone
(704) 403-9177
Fax
(704) 403-9178
NPI assigned
Sep 27, 2013
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Thomas F Laymon
Title
Sr Vice President
Phone
(704) 403-2276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1090 Northeast Gateway Court NE
Suite 101
Concord, NC 28025-2440

Mailing address

1090 Northeast Gateway Court NE
Suite 101
Concord, NC 28025-2440
Phone (704) 403-9177

Other names 1

  • Heart Success Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100309000605 NC Part B Supplier - Clinic/Group Practice 2961310685 Receives reassigned benefits from 1,831 practitioners
This NPI is an additional NPI on the enrollment

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
34D2077912Charlotte Mecklenburg Hospital Authority1090 Northeast Gateway Court, Suite 102, Concord, NC 28025Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Medical Center104 organizations share this tax ID, including this one
Part of
Carolinas Medical Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1841627437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHEAST GATEWAY COURT NE",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252440",
            "telephone_number": "704-403-9177",
            "fax_number": "704-403-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NORTHEAST GATEWAY COURT NE",
            "address_2": "SUITE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252440",
            "telephone_number": "704-403-9177",
            "fax_number": "704-403-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2013-09-27",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-2276"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart Success Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.