The Charlotte-Mecklenburg Hospital Authority

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0464 Issued in NC

Legal business name

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Doing business as

Stanly Manor

Practice address

625 Bethany Road
Albemarle, NC 28001

Phone

(704) 984-7344

NPI assigned

Nov 17, 2015

Last updated

Nov 17, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITYAs reported in NPPES

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

Authorized official

Name

Greg A Gombar

Title

Executive Vice President and Chief

Phone

(704) 355-2154

Specialties & licenses 1

Addresses

Other names 1

• Stanly Manor Doing business as

Part of

Carolinas Medical Center

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1942674775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602006",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602066",
            "telephone_number": "704-512-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BETHANY ROAD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-984-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "GOMBAR",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND CHIEF",
        "authorized_official_telephone_number": "704-355-2154"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanly Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Stanly)
• The Charlotte-Mecklenburg Hospital Authority (Carolinas HealthCare System Neurosciences Institute)
• The Charlotte-Mecklenburg Hospital Authority (NorthEast Plastic & Reconstructive Surgery-Albemarle)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Stanly)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Behavioral Health Psychiatry & Counseling)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Stanly Behavioral Health)
• The Homeplace Rest & Retirement
• The Life Change Group NC-Consulting
• The Mental Health Association in North Carolina, Inc (Stanly PSR)
• The Mental Health Association in North Carolina, Inc. (Waverly House)

• Skilled Nursing Facility in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.