DR. EMMETT FULCHER MONTGOMERY (NPI# 1356337646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356337646 |
| Entity Type | Individual |
| Full Name | DR. EMMETT FULCHER MONTGOMERY |
| Credential | MD |
| Practice Address |
435 E Statesville Ave Mooresville NC 28115-2598 |
| Mailing Address |
Po Box 1845 Statesville NC 28687-1845 |
| Practice Telephone | 7046635056 |
| Practice Fax Number | 7046635780 |
| Mailing Telephone | 7046635056 |
| Mailing Fax Number | 7046635780 |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2018-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35242 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8960083 | 05 |
| Street Address |
435 E STATESVILLE AVE |
| City | MOORESVILLE |
| State | NC |
| Zip Code | 28115-2598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730174608 | James W Mcnabb | Family Medicine | 435 E Statesville Ave, Mooresville, NC 28115-2598 | 2005-09-15 |
| 1104470434 | Jacqueline Swope | Registered Nurse | 435 E Statesville Ave, Mooresville, NC 28115-2598 | 2019-07-25 |
| 1225501877 | Piedmont Healthcare, Pa | Family Medicine | 435 E Statesville Ave, Mooresville, NC 28115-2598 | 2019-01-07 |
| 1215246590 | Karen Alden Carson | Nurse Practitioner | 435 E Statesville Ave, Mooresville, NC 28115 | 2010-10-04 |
| 1376792549 | Piedmont Healthcare, Pa | Durable Medical Equipment & Medical Supplies | 435 E Statesville Ave, Mooresville, NC 28115-2598 | 2008-09-12 |
| 1740323591 | Linda O'neil | Nurse Practitioner | 435 E Statesville Ave, Mooresville, NC 28115-2598 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376172338 | Shawn Booth | Counselor | 111 Laporte Lane, Mooresville, NC 28115 | 2020-04-02 |
| 1407418262 | Carlyn Jean Malenfant | Dentist | Loveland Dental Group of Mooresville, 134 N. Magnolia Street, Mooresville, NC 28115 | 2019-07-02 |
| 1619435906 | Loveland Dental Group of Mooresville | Dentist | 134 N. Magnolia Street, Mooresville, NC 28115 | 2019-03-06 |
| 1801317383 | Jessie Watts Gogg | Social Worker | 138 Shepherd Rd, Mooresville, NC 28115 | 2017-07-05 |
| 1063869469 | Amber Hicks-thibodeau | Family Medicine | 798 Oak Ridge Farm Hwy. Suite A, Mooresville, NC 28115 | 2016-05-16 |
| 1003286774 | Lauren Holscher | Speech-Language Pathologist | 3369 Deal Rd, Mooresville, NC 28115 | 2015-10-06 |
| 1629460217 | Jenny S Ryerson | Social Worker | 919 N Main St Ste B, Mooresville, NC 28115 | 2015-02-19 |
| 1720495435 | Lindsey Gardner | Pharmacist | 966 E Iredell Ave., Mooresville, NC 28115 | 2014-07-14 |
| 1568899169 | Saloni Mehta | Physical Therapist | 550 Glenwood Drive, Genesis Rehab, Charlotte, NC 28115 | 2013-09-27 |
| 1528312600 | Ronnie G. Davidson II Dmd Pa | Dentist | 134 N. Magnolia St., Mooresville, NC 28115 | 2012-10-29 |
| Find all providers in zip 28115 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868155 | Novant Medical Group, Inc. | Family Medicine | 106 Corporate Park Dr Ste 200, Mooresville, NC 28117-7134 | 2020-07-08 |
| 1649890468 | Carolinas Physicians Network Inc | Family Medicine | 150 Professional Park Dr Ste 400, Mooresville, NC 28117-5604 | 2020-04-22 |
| 1275080954 | Carolinas Physicians Network Inc | Family Medicine | 119-d-1 Marketplace Avenue, Mooresville, NC 28117-9157 | 2016-09-09 |
| 1063869469 | Amber Hicks-thibodeau | Family Medicine | 798 Oak Ridge Farm Hwy. Suite A, Mooresville, NC 28115 | 2016-05-16 |
| 1982043535 | Gabriel Cyrus Fitton | Family Medicine | 157 Professional Park Dr Ste A, Mooresville, NC 28117-5606 | 2013-06-17 |
| 1245573807 | Anthony John Castiglia | Family Medicine | 570 Williamson Rd, Suite C, Mooresville, NC 28117-9118 | 2013-04-02 |
| 1851678767 | Mooresville Ppm LLC | Family Medicine | 128 Argus Ln, Suite G, Mooresville, NC 28117-6972 | 2011-11-05 |
| 1790068096 | Urgent Cares of America North Carolina Inc. | Family Medicine | 107 Commons Dr Ste A, Mooresville, NC 28117-9262 | 2011-09-22 |
| 1780822288 | Iredell Physician Network LLC | Family Medicine | 136 Corporate Park Dr, Suite 3h, Mooresville, NC 28117-6959 | 2009-01-22 |
| 1275781726 | Carolinas Physicians Network, Inc. | Family Medicine | 478 Williamson Road, Ste B, Mooresville, NC 28117-9109 | 2008-09-08 |
| Find all providers in MOORESVILLE | ||||
| City | MOORESVILLE |
| Zip Code | 28115 |
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| 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.