NPIMap

Organization Active NPI

Calvary Community Medical

  • Primary Care Clinic/Center
  • Charlotte, NC
National Provider Identifier
1972905644
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
5007063 Issued in NC
Legal business name
CALVARY COMMUNITY MEDICAL
Practice address
537 W Sugar Creek Rd
Suite 201
Charlotte, NC 28213-6102
Phone
(704) 979-8210
Fax
(187) 749-2888
NPI assigned
Sep 24, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Okyere Bonna
Title
Administrator
Phone
(704) 526-9052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 5007063 NC Primary

Addresses

Primary practice location

537 W Sugar Creek Rd
Suite 201
Charlotte, NC 28213-6102

Mailing address

16725 Winston Oaks CT
Charlotte, NC 28213-5206
Phone (704) 534-1035

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1972905644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16725 WINSTON OAKS CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135206",
            "telephone_number": "704-534-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W SUGAR CREEK RD",
            "address_2": "SUITE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282136102",
            "telephone_number": "704-979-8210",
            "fax_number": "187-749-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVARY COMMUNITY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "BONNA",
        "authorized_official_first_name": "OKYERE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-526-9052"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "5007063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.