IREDELL MEMORIAL HOSPITAL, INCORPORATED (NPI# 1699838912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699838912 |
| Entity Type | Organization |
| Organization Name | IREDELL MEMORIAL HOSPITAL, INCORPORATED |
| Other Organization Name | IMH DIABETES CENTER |
| Practice Address |
557 Brookdale Dr Statesville NC 28677-4107 |
| Practice Telephone | 7048735661 |
| Mailing Telephone | 7048735661 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2010-08-03 |
| Authorized Official Name | MR. ED RUSH (PRESIDENT) |
| Authorized Official Telephone | 7048735661 |
| Is Organization Subpart | Y |
| Parent Organization Name | IREDELL MEMORIAL HOSPITAL, INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
003515 | NC | Nursing Service Providers |
| Other Name | Type Code |
|---|---|
| IMH Diabetes Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548230204 | Iredell Memorial Hospital, Incorporated | General Acute Care Hospital | 557 Brookdale Dr, Statesville, NC 28677 | 2006-01-25 |
| 1417944224 | Iredell Memorial Hospital, Incorporated | General Acute Care Hospital | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2005-10-06 |
| Street Address |
557 BROOKDALE DR |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982606281 | Rocco Joseph Tritico | Specialist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2005-06-01 |
| 1396216735 | Wake Forest Emergency Providers | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4100 | 2018-12-11 |
| 1255807517 | Sarah E Pagano | Nurse Anesthetist, Certified Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-10-15 |
| 1023503265 | Cecilia Kaechele | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677 | 2018-06-29 |
| 1063900512 | Amanda L Downs | Dietitian, Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-04-30 |
| 1275049207 | Holly Townsend | Specialist/Technologist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-12-28 |
| 1982115846 | Kayla Pierce | Registered Nurse | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-10-18 |
| 1245757665 | Wake Forest University Health Sciences | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-08-25 |
| 1609259183 | Nunta Campbell | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-07-02 |
| 1811381593 | Iredell Physician Network LLC | General Practice | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-03-20 |
| Find all providers in the same location | ||||
| 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 | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922546928 | Tina Hunt | Registered Nurse | 2934 N Elm St Ste G, Lumberton, NC 28358-2987 | 2017-02-09 |
| 1881070910 | Kimberly Warlick | Registered Nurse | 216 Mantle Dr, Clayton, NC 27527-3972 | 2015-07-30 |
| 1396929360 | Robert Luka | Registered Nurse | 445 Biltmore Ave Ste 203, Asheville, NC 28801-4529 | 2007-12-26 |
| 1477644904 | Waynette Twiford Speight | Registered Nurse | 711 Roanoke Avenue, Elizabeth City, NC 27909 | 2006-09-28 |
| 1104437342 | Bradley James Denmeade | Registered Nurse | 10207 Cerny St, Raleigh, NC 27617-4879 | 2020-08-12 |
| 1386200616 | Wendy Richardson Moore | Registered Nurse | 901 N Winstead Ave, Rocky Mount, NC 27804-8467 | 2019-05-13 |
| 1588228134 | Teresa Anne Raxter | Registered Nurse | 260 Hospital Dr, Brevard, NC 28712-3378 | 2019-04-30 |
| 1831669399 | Barbara Lesperance | Registered Nurse | 1390 Capital Blvd, Raleigh, NC 27603-1118 | 2018-11-27 |
| 1285111252 | Anna Burke Baird | Registered Nurse | 1301 Commerce Dr, New Bern, NC 28562-2213 | 2018-07-23 |
| 1992298012 | Sandra Harrison Rakestraw | Registered Nurse | 103 W Stadium Dr, Eden, NC 27288-3329 | 2018-06-13 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28677 |
Please comment or provide details below to improve the information on IREDELL MEMORIAL HOSPITAL, INCORPORATED.
| 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.