Caromont Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CAROMONT MEDICAL GROUP INC

Doing business as

CaroMont Integrative Family Medicine

Practice address

2711 X Ray Dr
Gastonia, NC 28054-7491

Phone

(704) 834-2450

Fax

(704) 671-5331

NPI assigned

Feb 9, 2011

Last updated

Mar 20, 2015By 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

Douglas R Luckett

Title

President/Ceo

Phone

(704) 834-2450

Specialties & licenses 1

Addresses

Other names 1

• CaroMont Integrative Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1871899898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5168",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547491",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "704-834-2450"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CaroMont Integrative Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caromont Medical Group Inc (CaroMont Vascular Center)
• Caromont Medical Group Inc (CaroMont Rheumatology)
• Caromont Medical Group Inc (CaroMont Health Maternity Clinic)
• Caromont Medical Group Inc (CaroMont Inpatient Neurology)
• Caromont Medical Group Inc (CaroMont Internal Medicine)
• Caromont Medical Group Inc (CaroMont Health Cancer Clinic)
• Caromont Medical Group Inc (The Hand Center of the Carolinas)
• Caromont Medical Group Inc (CaroMont Family Medicine)
• Caromont Medical Group Inc (Gastonia Surgical Associates)
• Caromont Medical Group Inc (CaroMont Family Medicine)

• Family Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.