Physician Onboarding

To ensure a smooth transition, please download, complete and return the forms below to:

Elizabeth McCourry, Credentialing and Enrollment Specialist
Phone: 704.671.5326
Fax: 704.671.5308

c/o CMG-Business Service
936 Cox Road
Gastonia, NC 28054
credentialing@caromonthealth.org

Physician Onboarding Forms:

CMG Signature Log

Credentialing Application

DEA Address Change

Payer Signature

Provider Demographics

Waiver For Claims History