Caromont- South Point LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CAROMONT- SOUTH POINT LLC

Doing business as

South Point Family Practice

Practice address

159 E Dallas Rd
Stanley, NC 28164-2052

Phone

(704) 263-0300

Fax

(704) 263-1873

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

David M Oconnor

Title

Cfo

Phone

(704) 834-2133

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Point Family Practice Doing business as

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1932388568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 E DALLAS RD",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281642052",
            "telephone_number": "704-263-0300",
            "fax_number": "704-263-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E DALLAS RD",
            "city": "STANLEY",
            "state": "NC",
            "postal_code": "281642052",
            "telephone_number": "704-263-0300",
            "fax_number": "704-263-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT- SOUTH POINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-834-2133"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905652",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Point Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Point Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Daniel Brown, PA-C
• Shameka L Brown
• Toni Michelle Brown, BSPS, PHARMD, RPH
• Caromont Medical Group Inc (CaroMont Family Medicine)
• Caromont Medical Group Inc
• Jennifer Case, PHD, RD, CSSD, CSCS
• David Blake Cason, D.C.
• Jennifer Ann Caudell, MPT
• Amy Carpenter Chapman
• Brittany Wyatt Chestnut, NP-C

• Family Medicine Physician in Stanley, NC
• Providers in Stanley, 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 Apr 25, 2019; 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.