IREDELL PHYSICIAN NETWORK LLC (NPI# 1235410960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235410960 |
| Entity Type | Organization |
| Organization Name | IREDELL PHYSICIAN NETWORK LLC |
| Other Organization Name | STATESVILLE CARDIOVASCULAR CLINIC |
| Practice Address |
738 Bryant St Ste A Statesville NC 28677-4189 |
| Practice Telephone | 7048731189 |
| Mailing Telephone | 7048731189 |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |
| Authorized Official Name | ANNA PURCELL (DIR. MANAGED CARE) |
| Authorized Official Telephone | 7048784569 |
| Is Organization Subpart | Y |
| Parent Organization Name | IREDELL PHYSICIAN NETWORK LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Statesville Cardiovascular Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154609147 | Iredell Physician Network LLC | Internal Medicine | 1714 Davie Ave, Statesville, NC 28677-3522 | 2011-07-26 |
| 1639318751 | Iredell Physician Network LLC | Family Medicine | 955 West Memorial Highway, Harmony, NC 28634-9352 | 2009-02-12 |
| 1780822288 | Iredell Physician Network LLC | Family Medicine | 136 Corporate Park Dr, Suite 3h, Mooresville, NC 28117-6959 | 2009-01-22 |
| 1487840427 | Iredell Physician Network LLC | Family Medicine | 774 Hartness Rd, Statesville, NC 28677-3376 | 2007-09-24 |
| 1578073631 | Iredell Physician Network LLC | Clinic/Center | 707 Bryant St, Statesville, NC 28677-4142 | 2017-10-03 |
| 1497139398 | Iredell Physician Network LLC | Clinic/Center | 3210 Harmony Hwy, Harmony, NC 28634-9161 | 2015-07-10 |
| 1124402946 | Iredell Physician Network LLC | Clinic/Center | 1668 Nc Highway 16 S, Taylorsville, NC 28681-6285 | 2015-07-10 |
| 1811381593 | Iredell Physician Network LLC | General Practice | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-03-20 |
| 1235433806 | Iredell Physician Network LLC | Internal Medicine | 757 Bryant St, Statesville, NC 28677-4142 | 2010-12-22 |
| 1205136595 | Iredell Physician Network LLC | Internal Medicine | 510 N Main St, Troutman, NC 28166-9529 | 2010-11-02 |
| Street Address |
738 BRYANT ST STE A |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-4189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053348607 | Jill Suzanne Calhoun | Physician Assistant | 738 Bryant St Ste A, Statesville, NC 28677-4189 | 2006-06-27 |
| 1558703090 | Maryna Rudenko Yacinthe | Nurse Practitioner | 738 Bryant St Ste A, Statesville, NC 28677-4189 | 2013-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
| 1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
| 1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
| 1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
| 1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
| 1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
| 1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
| 1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
| Find all providers in zip 28677 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306081302 | Novant Medical Group, Inc. | Internal Medicine | 349 Brookdale Dr, Statesville, NC 28677-4103 | 2008-12-05 |
| 1669464160 | Keith A Gatlin | Internal Medicine | 766 Hartness Rd, Statesville, NC 28677-3425 | 2005-08-19 |
| 1366434862 | Ray I Georgeson | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2005-08-19 |
| 1235121997 | John J. Allan | Internal Medicine | 1424 Fern Creek Dr, Suite D, Statesville, NC 28625-9376 | 2005-08-18 |
| 1649636085 | Regional Physicians LLC | Internal Medicine | 218 Old Mocksville Rd, Statesville, NC 28625-1930 | 2016-01-14 |
| 1275914046 | Cornerstone Health Care Pa | Internal Medicine | 218 Old Mocksville Rd, Statesville, NC 28625-1930 | 2015-06-17 |
| 1497031314 | Statesville Hma Medical Group, LLC | Internal Medicine | 349 Brookdale Dr, Statesville, NC 28677-4103 | 2011-10-24 |
| 1114032398 | James Hedrick Bradford | Internal Medicine | 738 Bryant St, Suite A, Statesville, NC 28677-4189 | 2006-08-20 |
| 1932214137 | Naim Ezzat Bouhussein | Internal Medicine | 738 Bryant St, Suite A, Statesville, NC 28677-4189 | 2006-08-20 |
| 1558476606 | Statesville Cardiovascular Clinic Pa | Internal Medicine | 738 Bryant St, Suite A, Statesville, NC 28677-4189 | 2006-08-20 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
Please comment or provide details below to improve the information on IREDELL PHYSICIAN NETWORK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.