IREDELL PHYSICIAN NETWORK LLC (NPI# 1487840427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487840427 |
| Entity Type | Organization |
| Organization Name | IREDELL PHYSICIAN NETWORK LLC |
| Other Organization Name | YOUNG FAMILY PRACTICE |
| Practice Address |
774 Hartness Rd Statesville NC 28677-3376 |
| Mailing Address |
Po Box 25867 Winston Salem NC 27114-5867 |
| Practice Telephone | 7049247992 |
| Practice Fax Number | 7049247950 |
| Mailing Telephone | 7049247992 |
| Mailing Fax Number | 7049247950 |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2010-05-12 |
| Authorized Official Name | MS. ANNA PURCELL (DIRECTOR) |
| 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 | 207Q00000X | Family Medicine | 96-00787 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5908193 | 05 |
| Other Name | Type Code |
|---|---|
| Young Family Practice | 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 |
| 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 |
| 1235410960 | Iredell Physician Network LLC | Internal Medicine | 738 Bryant St Ste A, Statesville, NC 28677-4189 | 2011-09-08 |
| 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 |
774 HARTNESS RD |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902271851 | Whitney Alexandria Reavis | Neurological Surgery | 774 Hartness Rd, Statesville, NC 28677-3376 | 2015-12-03 |
| 1023402732 | Iredell Physician Network | Neurological Surgery | 774 Hartness Rd, Statesville, NC 28677-3376 | 2015-03-20 |
| 1609205103 | Rachel Robertson | Physician Assistant | 774 Hartness Rd, Statesville, NC 28677-3376 | 2013-11-05 |
| 1720246341 | Iredell Physician Network LLC | Orthopaedic Surgery | 774 Hartness Rd, Statesville, NC 28677-3376 | 2008-05-30 |
| 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 | 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 |
|---|---|---|---|---|
| 1699300822 | Carolinas Regenerative Medicine, Pllc | Family Medicine | 1661 Davie Ave, Statesville, NC 28677-3519 | 2020-03-09 |
| 1639649510 | Piedmont Healthcare, Pa | Family Medicine | 276 Old Mocksville Rd Ste 400, Statesville, NC 28625-1950 | 2018-12-04 |
| 1407114176 | Urgent Cares of America North Carolina Inc. | Family Medicine | 242 Turnersburg Hwy, Statesville, NC 28625-2797 | 2012-05-01 |
| 1639407737 | Statesville Hma Medical Group, LLC | Family Medicine | 1412 Fern Creek Dr, Statesville, NC 28625-9376 | 2009-12-01 |
| 1629242490 | Samuel Ekro Inkumsah | Family Medicine | 555 Kitchings Dr Ste D, Statesville, NC 28677-3576 | 2008-04-14 |
| 1528164324 | Omodele Julie Masha | Family Medicine | 518 Brookdale Dr, Statesville, NC 28677-4108 | 2006-09-16 |
| 1225134166 | Miller Family Practice PC | Family Medicine | 513 Brookdale Drive, Statesville, NC 28677 | 2006-09-16 |
| 1376645549 | Teresa Romzick | Family Medicine | 2341 Simonton Rd, Statesville, NC 28625-8246 | 2006-09-01 |
| 1124046198 | Life Enhancement Medical Services Pllc | Family Medicine | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2006-07-18 |
| 1700855020 | David Wayne Cash | Family Medicine | 310 Davie Ave, Statesville, NC 28677-5319 | 2006-03-17 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
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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.