Healthcare Provider Details

I. General information

NPI: 1528085313
Provider Name (Legal Business Name): ORTHOCAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 W KING ST SUITE 100-C
KINGS MOUNTAIN NC
28086-3362
US

IV. Provider business mailing address

4601 PARK RD STE 300
CHARLOTTE NC
28209-3239
US

V. Phone/Fax

Practice location:
  • Phone: 704-739-0277
  • Fax: 704-339-1444
Mailing address:
  • Phone: 704-323-2256
  • Fax: 704-323-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: TOM F LAYMON
Title or Position: CEO
Credential:
Phone: 704-339-1000