NPIMap

Organization Active NPI

Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1982883583
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAROMONT MEDICAL GROUP INC
Practice address
1895 Hoffman Road
Suite a
Gastonia, NC 28054-6557
Phone
(704) 865-1749
Fax
(704) 865-7328
NPI assigned
Oct 31, 2007
Organization subpart
Yes
Parent organization
CAROMONT MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
David Michael Oconnor
Title
Cfo
Phone
(704) 834-2049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1895 Hoffman Road
Suite a
Gastonia, NC 28054-6557

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other identifiers 2

IdentifierTypeStateIssuer
1982883583MedicaidNC
0165AOtherNCBCBS

Other names 1

  • CaroMont Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000070 NC Part B Supplier - Clinic/Group Practice 3577476258 Receives reassigned benefits from 760 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Gastonia, NC; Kings Mountain, NC; Lenoir, NC; McAdenville, NC; Morganton, NC; Shelby, NC; Stanley, NC; Belmont, NC…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0963807Caromont Family Medicine1895 Hoffman Road, Suite a, Gastonia, NC 28054Provider-performed microscopyAug 9, 2027

National Provider Directory

National Provider Directory
Part of
Gaston Health Resources

Locations

1895 Hoffman Rd
#A
Gastonia, NC 28054
Phone (704) 865-1749

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1982883583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 HOFFMAN ROAD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280546557",
            "telephone_number": "704-865-1749",
            "fax_number": "704-865-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROMONT MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROMONT MEDICAL GROUP INC",
        "enumeration_date": "2007-10-31",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-834-2049"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982883583",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0165A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CaroMont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CaroMont Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.