NPIMap

Organization Active NPI

Cleveland Health Ventures LLC

  • Family Medicine Physician
  • Shelby, NC
National Provider Identifier
1891063277
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLEVELAND HEALTH VENTURES LLC
Practice address
1010 E Dixon Blvd
Shelby, NC 28152-6838
Phone
(980) 487-2900
Fax
(980) 487-2901
NPI assigned
Dec 13, 2011
Organization subpart
Yes
Parent organization
CLEVELAND HEALTH VENTURES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Daniel Wiens
Title
Senior Vice President
Phone
(704) 355-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1010 E Dixon Blvd
Shelby, NC 28152-6838

Mailing address

PO Box 601884
Charlotte, NC 28260-1884
Phone (980) 487-2900

Other identifiers 2

IdentifierTypeStateIssuer
7705426OtherNCNC MEDICAID DME
5919549MedicaidNC

Other names 1

  • Carolinas Healthcare Urgent Care Shelby Doing business as

National Provider Directory

National Provider Directory
Part of
Carolinas Hospitalist Group

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1891063277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601884",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601884",
            "telephone_number": "980-487-2900",
            "fax_number": "980-487-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526838",
            "telephone_number": "980-487-2900",
            "fax_number": "980-487-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND HEALTH VENTURES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEVELAND HEALTH VENTURES LLC",
        "enumeration_date": "2011-12-13",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "WIENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "704-355-0648"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID DME",
            "identifier": "7705426",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919549",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Healthcare Urgent Care Shelby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.