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Carolinas Medical Center

Organization Active NPI Adult Mental Health Clinic/Center · Charlotte, NC

NPI 1972792869 · NPPES record last updated Oct 17, 2007

Key facts

NPI
1972792869
Entity type
Organization (NPI type 2)
Primary specialty
Adult Mental Health Clinic/Center 261QM0850X
License
H0071 (NC)
Legal business name
CAROLINAS MEDICAL CENTER
Practice address
501 Billingsley Road
Behavioral Health Center CMC Randolph
Charlotte, NC 28211-1009
Phone
(704) 444-2520
Fax
(704) 444-2532
NPI assigned
Oct 17, 2007
Organization subpart
No

Authorized official

Name
Thomas E. Gettelman, PHD
Title
Assistant Vice President
Phone
(704) 444-2406

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ctr for Mental Health (69 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X H0071 NC Yes

Addresses

Primary practice location

501 Billingsley Road
Behavioral Health Center CMC Randolph
Charlotte, NC 28211-1009

Mailing address

501 Billingsley Road
Behavioral Health Center CMC Randolph
Charlotte, NC 28211-1009
Phone (704) 358-2710

Other identifiers

IdentifierTypeStateIssuer
8300443AMedicaidNC

Other names

  • BHC CMCR Assertive Treatment Team Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2007.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1972792869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY ROAD",
            "address_2": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-358-2710",
            "fax_number": "704-358-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BILLINGSLEY ROAD",
            "address_2": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111009",
            "telephone_number": "704-444-2520",
            "fax_number": "704-444-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "GETTELMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT VICE PRESIDENT",
        "authorized_official_telephone_number": "704-444-2406",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "H0071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300443A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BHC CMCR Assertive Treatment Team",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

All providers in Charlotte, NC · Adult Mental Health Clinic/Center in North Carolina

Sources for this page

Verify at the official NPI Registry.