Organization Active NPI

Cabarrus Ear Nose Throat & Facial Surgery Center PA

  • Facial Plastic Surgery Physician
  • Concord, NC
National Provider Identifier
1962535252
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
39284 Issued in NC
Legal business name
CABARRUS EAR NOSE THROAT & FACIAL SURGERY CENTER PA
Practice address
1018 Lee Ann Dr NE
Concord, NC 28025-2911
Phone
(704) 782-7111
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Mr. Robert Clayton Jarchow, M.D.
Title
Medical Doctor
Phone
(704) 782-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0123X 39284 NC Primary

Addresses

Primary practice location

1018 Lee Ann Dr NE
Concord, NC 28025-2911

Mailing address

1018 Lee Ann Dr NE
Concord, NC 28025-2911
Phone (704) 782-7111

Other identifiers 1

IdentifierTypeStateIssuer
890183RMedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1962535252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252911",
            "telephone_number": "704-782-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABARRUS EAR NOSE THROAT & FACIAL SURGERY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "JARCHOW",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "704-782-7111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NC",
            "license": "39284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890183R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.