Provider Demographics
NPI:1245462993
Name:CARTERS CIRCLE OF CARE, INC.
Entity type:Organization
Organization Name:CARTERS CIRCLE OF CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALIFIED PROFESSIONAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-271-5888
Mailing Address - Street 1:2031 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3342
Mailing Address - Country:US
Mailing Address - Phone:336-271-5888
Mailing Address - Fax:336-271-5882
Practice Address - Street 1:2031 MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE E
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3342
Practice Address - Country:US
Practice Address - Phone:336-254-8843
Practice Address - Fax:336-271-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302851Medicaid