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CAROMONT URGENT CARE
NPI 1609467760
Family Medicine in Lake Wylie, SC

Active since February 01, 2021CLIA 42D2213658 · Waiver
1201 VILLAGE HARBOR DR STE 104, LAKE WYLIE, SC 29710(803) 831-6859(803) 831-6860 Get Directions Write a Review

NPPES record last updated: August 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 9, 2022, Feb 3, 2021 (2 updates tracked since 2021).

About Caromont Urgent Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAROMONT URGENT CARE (NPI 1609467760) is a healthcare organization registered as a family medicine in Lake Wylie, South Carolina and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through February 15, 2027 and lists David Michael Oconnor, Cfo, as its authorized official.

NPPES Registry Identity

NPI1609467760
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCAROMONT MEDICAL GROUP, INC.
Location Address1201 VILLAGE HARBOR DR STE 104Lake Wylie, SC 29710-9276
Mailing AddressPo Box 744786Atlanta, GA 30374-4786 · (704) 834-2450 · Fax (704) 671-5331
Phone(803) 831-6859
Fax(803) 831-6860
Organization SubpartYesParent: Caromont Medical Group Inc
Authorized OfficialDavid Michael OconnorCfo · (704) 834-2049
Enumeration DateFebruary 1, 2021
Last NPPES UpdateAugust 9, 20222 updates tracked since enumeration
NPPES CertifiedAugust 9, 2022
✔ NPI 1609467760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1201 VILLAGE HARBOR DR STE 104, Lake Wylie, SC 29710
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Other Names 1

Doing Business AsCaromont Urgent Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, BlueCross BlueShield of South Carolina.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2213658

Caromont Urgent Care-Lake Wylie · Lake Wylie, SC
Active · expires Feb 15, 2027
CLIA Number42D2213658
Laboratory TypePhysician Office
Certificate Effective DateFebruary 16, 2025
Certificate Expiration DateFebruary 15, 2027
Laboratory DirectorDr. Sarah Kabemba Tshitenge
Laboratory Phone(803) 831-6859
Laboratory LocationCaromont Urgent Care-Lake Wylie1201 Village Harbor Drive Suite 104 Attn Becky Stuman, Lake Wylie, SC 29710
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLEN CHRISTINE HIBBERTS PA
Physician Assistant (Medical)
1201 VILLAGE HARBOR DR STE 104
LAKE WYLIE, SC 29710
York County (803) 831-6859
MALEENA ELIZABETH PAYNE PA-C
Physician Assistant
1201 VILLAGE HARBOR DR STE 104
LAKE WYLIE, SC 29710
York County (803) 831-6859

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Caromont Medical Group, Inc.'s NPI number?

The NPI number for Caromont Medical Group, Inc. is 1609467760. It was assigned to this organization in the NPPES registry on February 1, 2021. The provider is doing business as Caromont Urgent Care.

Where is Caromont Medical Group, Inc. located?

Caromont Medical Group, Inc. is located at 1201 Village Harbor Dr Ste 104, Lake Wylie, SC 29710. The listed phone number is (803) 831-6859.

What is Caromont Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Caromont Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2213658) is associated with this NPI, valid through February 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Caromont Medical Group, Inc. accept?

Health plans from Blue Cross and Blue Shield of NC and BlueCross BlueShield of South Carolina list Caromont Medical Group, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Caromont Medical Group, Inc. was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.