IREDELL PHYSICIAN NETWORK LLC (NPI# 1578073631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578073631 |
| Entity Type | Organization |
| Organization Name | IREDELL PHYSICIAN NETWORK LLC |
| Practice Address |
707 Bryant St Statesville NC 28677-4142 |
| Mailing Address |
557 Brookdale Dr Statesville NC 28677-4107 |
| Practice Telephone | 7048735224 |
| Mailing Telephone | 7048784959 |
| Mailing Fax Number | 7048787664 |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |
| Authorized Official Name | EMILY MCGEE (CONTRACTS/CREDENTIALING) |
| Authorized Official Telephone | 7042520744 |
| Is Organization Subpart | Y |
| Parent Organization Name | IREDELL PHYSICIAN NETWORK LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| 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 |
| 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 |
707 BRYANT ST |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-4142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366434870 | Alan E Deddens | Otolaryngology | 707 Bryant St, Statesville, NC 28677-4142 | 2005-08-19 |
| 1396249660 | Diagnostic Audiology and Hearing Aid Services | Clinic/Center | 707 Bryant St, Statesville, NC 28677-4142 | 2018-03-21 |
| 1336517762 | Jessica Schmidt | Audiologist | 707 Bryant St, Statesville, NC 28677-4142 | 2015-09-02 |
| 1831406933 | Angelia S Natili | Otolaryngology | 707 Bryant St, Statesville, NC 28677-4142 | 2010-09-10 |
| 1427152123 | David Clifford Richardson | Audiologist | 707 Bryant St, Statesville, NC 28677 | 2006-09-12 |
| 1710956529 | Iredell Head, Neck and Ear Ambulatory Surgery Center, Inc. | Clinic/Center | 707 Bryant St, Lower Level, Statesville, NC 28677-4142 | 2006-03-15 |
| 1255322681 | Mark L Prendergast | Otolaryngology | 707 Bryant St, Statesville, NC 28677-4142 | 2005-11-03 |
| 1609868132 | Steven J Landau | Otolaryngology | 707 Bryant St, Statesville, NC 28677-4142 | 2005-08-19 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437269800 | Iredell Surgical Associates, LLP | Clinic/Center | 1720 Davie Ave, Statesville, NC 28677-3522 | 2006-08-30 |
| 1710956529 | Iredell Head, Neck and Ear Ambulatory Surgery Center, Inc. | Clinic/Center | 707 Bryant St, Lower Level, Statesville, NC 28677-4142 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342481 | Piedmont Asc LLC | Clinic/Center | 7819 National Service Rd Ste 404, Greensboro, NC 27409-9401 | 2020-10-02 |
| 1558983833 | Triad Center for Surgery, LLC | Clinic/Center | 180 Kimel Park Dr Ste 200, Winston Salem, NC 27103-6970 | 2020-05-10 |
| 1922639426 | Associated Health Services, Inc. | Clinic/Center | 5601 Arringdon Park Dr, Morrisville, NC 27560-5643 | 2020-02-03 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1528521887 | Novant Health Clemmons Outpatient Surgery, LLC | Clinic/Center | 7210 Village Medical Circle, Suite # 235, Clemmons, NC 27012 | 2019-04-12 |
| 1437623626 | Prime Surgical Suites, LLC | Clinic/Center | 180 Riverbend Dr, Granite Falls, NC 28630 | 2019-01-22 |
| 1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
| 1124594338 | Charlotte Surgery Center, LLC | Clinic/Center | 3621 Randolph Rd Ste 200, Charlotte, NC 28211-0027 | 2018-10-16 |
| 1750892659 | Novant Health Kernersville Outpatient Surgery LLC | Clinic/Center | 1730 Kernersville Medical Pkwy Ste 304, Kernersville, NC 27284-7198 | 2017-10-18 |
| 1821510579 | Novant Health Brunswick Endoscopy Center, LLC | Clinic/Center | 13 Medical Campus Dr, Suite 101, Supply, NC 28462 | 2017-07-14 |
| Find all providers with the same taxonomy | ||||
| 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.