Active NPI
Caromont Medical Group Inc
- Surgery Physician
- Gastonia, NC
National Provider Identifier
1912296385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- CAROMONT MEDICAL GROUP INC
- Practice address
- 2525 Court Dr
Gastonia, NC 28054-2140 - Phone
- (704) 834-2000
- Fax
- (704) 834-2500
- NPI assigned
- Apr 6, 2011
- Organization subpart
- Yes
- Parent organization
- CAROMONT MEDICAL GROUP INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Michael Oconnor
- Title
- Cfo
- Phone
- (704) 834-2049
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
2525 Court Dr
Gastonia, NC 28054-2140
Mailing address
PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5917854 | Medicaid | NC |
Other names 1
- CaroMont Health Cancer Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Gaston Health Resources
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Raleigh, NC
- NPI 1114931607
-
- Surgery Physician
- Bluefield, VA
- NPI 1801868815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660003200000",
"number": "1912296385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744786",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303744786",
"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": "2525 COURT DR",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280542140",
"telephone_number": "704-834-2000",
"fax_number": "704-834-2500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROMONT MEDICAL GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CAROMONT MEDICAL GROUP INC",
"enumeration_date": "2011-04-06",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A",
"authorized_official_last_name": "OCONNOR",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "704-834-2049"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5917854",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CaroMont Health Cancer Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "CaroMont Health Cancer Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.