Individual provider Active NPI

Walter Harry Caulfield III, MD

  • Plastic and Reconstructive Surgery Physician
  • Gastonia, NC
National Provider Identifier
1982696522
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
9600399 Issued in NC
Practice address
2391 Court Dr
Suite 120
Gastonia, NC 28054-2196
Phone
(704) 874-0095
Fax
(704) 866-8680
NPI assigned
Aug 19, 2005
Last updated
Feb 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 9600399 NC Primary

Addresses

Primary practice location

2391 Court Dr
Suite 120
Gastonia, NC 28054-2196

Mailing address

2391 Court Dr
Suite 120
Gastonia, NC 28054-2196
Phone (704) 874-0095

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
I20070517000129 NC Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 8729013529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
University of Pittsburgh School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2391 Court Dr
Gastonia, NC 28054-2196

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy27
Melanoma (skin cancer) excision39
Removal of tissue1-10
Removal of skin lesions32
Skin biopsy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9600399NCMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Mar 15, 2011 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 15, 2011 Accepting new patients
CPSC CMG LLC Past Accepting new patients
Caromont Medical Group, Inc. Plastic and Reconstructive Surgery Past Accepting new patients
Southeastern Plastic Surgery PC Plastic and Reconstructive Surgery PastSince Apr 1, 2000 Accepting new patients

Locations

2391 Court Dr
Ste 120B
Gastonia, NC 28054
Phone (704) 874-0095

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

1200 Village Harbor Dr
Lake Wylie, SC 29710
Phone (704) 671-6400

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1982696522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2391 COURT DR",
            "address_2": "SUITE 120",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542196",
            "telephone_number": "704-874-0095",
            "fax_number": "704-866-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 COURT DR",
            "address_2": "SUITE 120",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542196",
            "telephone_number": "704-874-0095",
            "fax_number": "704-866-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAULFIELD",
        "first_name": "WALTER",
        "middle_name": "HARRY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "9600399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.