NPIMap

Organization Active NPI

Caldwell Memorial Hospital, Inc.

Doing business as McCreary Cancer Center

  • Medical Oncology Physician
  • Lenoir, NC
National Provider Identifier
1922426220
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
CALDWELL MEMORIAL HOSPITAL, INC.
Doing business as
McCreary Cancer Center
Practice address
212 Mulberry St SW
Lenoir, NC 28645-5414
Phone
(828) 759-4960
Fax
(828) 759-4961
NPI assigned
Apr 3, 2014
Last updated
Jun 16, 2023By 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 Jun 16, 2023

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU
Medical Oncology Physician 207RX0202X NU Primary

Addresses

Primary practice location

212 Mulberry St SW
Lenoir, NC 28645-5414

Mailing address

212 Mulberry St SW
Lenoir, NC 28645-5414
Phone (828) 759-4960

Other names 1

  • McCreary Cancer Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140723000690 NC Part B Supplier - Clinic/Group Practice 5395646970 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Lenoir, NC

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Caldwell Memorial Hosp Inc

Locations

212 Mulberry St SW
Ste 206
Lenoir, NC 28645
Phone (704) 754-0541

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1922426220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455414",
            "telephone_number": "828-759-4960",
            "fax_number": "828-759-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 MULBERRY ST SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455414",
            "telephone_number": "828-759-4960",
            "fax_number": "828-759-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2014-04-03",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "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": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCreary Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McCreary Cancer Center",
            "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 Jun 16, 2023; 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.