JOHN SARDELLA (NPI# 1356433171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356433171 |
| Entity Type | Individual |
| Full Name | JOHN SARDELLA |
| Credential | PA-C |
| Practice Address |
4654 Long Beach Rd Se Southport NC 28461-8799 |
| Mailing Address |
10250 Timber Ridge Ct Se Leland NC 28451-8536 |
| Practice Telephone | 9104579564 |
| Mailing Telephone | 9105201514 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
101496 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932245073 | John Vincent Sardella | Dentist | 1810 E Lincoln Hwy, Coatesville, PA 19320-2408 | 2007-01-29 |
| Street Address |
4654 LONG BEACH RD SE |
| City | SOUTHPORT |
| State | NC |
| Zip Code | 28461-8799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207749 | John D Irvin | Family Medicine | 4654 Long Beach Rd Se, Southport, NC 28461-8799 | 2005-09-29 |
| 1548711963 | Goshen Medical Center Incorporated | Clinic/Center | 4654 Long Beach Rd Se, Southport, NC 28461-8799 | 2016-10-20 |
| 1922414754 | Carolina Comprehensive Health | Clinic/Center | 4654 Long Beach Rd Se, Southport, NC 28461-8799 | 2014-07-01 |
| 1457590507 | Crystal Ammons Bates | Nurse Practitioner | 4654 Long Beach Rd Se, Southport, NC 28461-8799 | 2009-02-12 |
| 1912127994 | James R Forstner | Legal Medicine | 4654 Long Beach Rd Se, Southport, NC 28461-8799 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1871095356 | Sunny Point Fire & Rescue | Emergency Medicine | 6280 Sunny Point Rd Bldg 44, Southport, NC 28461 | 2018-03-01 |
| 1962882035 | Kimberlee Kreuzer | Physical Therapist | 1517 N Howe St Suite 4, Southport, NC 28461 | 2015-06-04 |
| 1134449291 | Kristos Nektarios Vaughan | Family Medicine | 3009 Medical Plaza Lane, Southport, NC 28461 | 2010-06-10 |
| 1750612974 | Melissa Holden | Nurse Practitioner | 1517 N Howe St Ste 12, Southport, NC 28461 | 2010-01-28 |
| 1437315165 | North Carolina Shoulder and Elbow Surgery and Sports Medicine | Orthopaedic Surgery | 900 North Howe St, Southport, NC 28461 | 2008-08-01 |
| 1124212329 | Edward Frank Babel | Nurse Practitioner | 201 West Boiling Spring Lakes Road, New Hope Clinic, Boiling Spring Lakes, NC 28461 | 2007-08-30 |
| 1952453151 | Robert Wayne Poe | Otolaryngology | 900 N. Howe St, Southport, NC 28461 | 2007-01-17 |
| 1275640898 | Kurt Thomas Scheetz | Dentist | 1301 N Howe Street, Southport, NC 28461 | 2006-08-23 |
| 1396859872 | Brunswick Family Medicine Pa | Family Medicine | 3960 Executive Park Blvd, Unit 600, Southport, NC 28461 | 2006-08-19 |
| Find all providers in zip 28461 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427049121 | Regina Z Gum | Physician Assistant | 5130 Southport Supply Rd Se, Ste 101, Southport, NC 28461-9261 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
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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.