NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc

Doing business as Mulberry Pediatrics

  • Pediatrics Physician
  • Lenoir, NC
National Provider Identifier
1922013457
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC
Doing business as
Mulberry Pediatrics
Practice address
906 College Ave SW
Suite C
Lenoir, NC 28645-5428
Phone
(828) 757-5509
Fax
(828) 757-5538
NPI assigned
Jul 31, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CALDWELL MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

906 College Ave SW
Suite C
Lenoir, NC 28645-5428

Mailing address

321 Mulberry St SW
Medical Staff Services
Lenoir, NC 28645-5720
Phone (828) 757-5965

Other identifiers 1

IdentifierTypeStateIssuer
890225KMedicaidNC

Other names 1

  • Mulberry Pediatrics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

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
34D0675576Mulberry Pediatrics Laboratory906 College Ave SW, Suite C, Lenoir, NC 28645Certificate of waiverMay 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Caldwell Podiatry Cente26 organizations share this tax ID, including this one
Part of
Caldwell Podiatry Cente

Other organizations with this tax ID 25

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

View all 25

Locations

8439 Valley Blvd
Blowing Rock, NC 28605
Phone (828) 295-3116

4355 Hickory Blvd
Ste 2
Granite Falls, NC 28630
Phone (828) 757-5050

4355 Hickory Blvd
Ste 3
Granite Falls, NC 28630
Phone (828) 757-5040

270 Pine Mountain Rd
Ste 4
Hudson, NC 28638
Phone (828) 757-6325

1733 Connelly Springs Rd
Lenoir, NC 28645
Phone (828) 728-2188

2651 Morganton Blvd SW
Lenoir, NC 28645
Phone (828) 757-8950

322 Mulberry St SW
Ste G
Lenoir, NC 28645
Phone (828) 757-6400

401 Mulberry St SW
Ste 202
Lenoir, NC 28645
Phone (828) 757-6146

401 Mulberry St SW
Ste 207
Lenoir, NC 28645
Phone (828) 757-6462

516 Mulberry St SW
Lenoir, NC 28645
Phone (828) 757-9733

907 College Ave SW Ste C
Lenoir, NC 28645

Practitioners & affiliated clinicians

Practitioners 131

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 131

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1922013457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MULBERRY ST SW",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455720",
            "telephone_number": "828-757-5965",
            "fax_number": "828-757-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 COLLEGE AVE SW",
            "address_2": "SUITE C",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455428",
            "telephone_number": "828-757-5509",
            "fax_number": "828-757-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-07-31",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890225K",
            "state": "NC"
        }
    ],
    "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": "Mulberry Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mulberry Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lenoir, 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 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.