Individual provider Active NPI

William C. Carr, MD

  • Pediatrics Physician
  • Clinton, NC
National Provider Identifier
1962430199
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29463 Issued in NC
Practice address
403 Fairview St
Clinton, NC 28328-2399
Phone
(910) 592-6011
NPI assigned
Jun 28, 2006
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29463 NC Primary

Addresses

Primary practice location

403 Fairview St
Clinton, NC 28328-2399

Mailing address

403 Fairview St
Clinton, NC 28328-2399
Phone (910) 592-6011

Other practice location 1

404 Fairview St
Clinton, NC 28328-2312
Phone (910) 592-6011

Other identifiers 6

IdentifierTypeStateIssuer
38627OtherNCMEDCOST
00387882MedicaidNC
21413OtherNCNC BLUE CROSS BLUE SHIELD
560955090DOtherNCCIGNA
1238872OtherNCUNITED HEALTHCARE
4652851OtherNCAETNA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address clintonmedicalclinic@cmci.allscriptsdirect.net Direct
Direct Messaging Address williamcarr@cmci.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041113000096 NC Practitioner - Pediatric Medicine 4385608959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29463NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton Medical Clinic, Inc. Pediatrics CurrentSince Aug 1, 1989 Accepting new patients

Locations

403 Fairview St
Clinton, NC 28328
Phone (910) 590-0619

404 Fairview St
Clinton, NC 28328
Phone (910) 592-6011

301 Main St
Newton Grove, NC 28366
Phone (910) 594-0003

Interoperability endpoints

  • Direct secure messaging: clintonmedicalclinic@cmci.allscriptsdirect.net
  • Direct secure messaging: wcarr10894@direct.unc.nchie.net
  • Direct secure messaging: williamcarr@cmci.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1962430199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Fairview St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "NC",
            "postal_code": "283282312",
            "country_code": "US",
            "telephone_number": "910-592-6011",
            "fax_number": "910-592-0819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "WILLIAM",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "29463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "38627",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00387882",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUE CROSS BLUE SHIELD",
            "identifier": "21413",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "560955090D",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1238872",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4652851",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clintonmedicalclinic@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Clinic DM Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message",
            "address_1": "404 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "williamcarr@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Provider DM address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message",
            "address_1": "404 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.