GARY KENNETH DEWEESE (NPI# 1790744225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790744225 |
| Entity Type | Individual |
| Full Name | GARY KENNETH DEWEESE |
| Credential | MD |
| Practice Address |
633 Brookdale Dr Ste 100 Statesville NC 28677-3471 |
| Mailing Address |
Po Box 1845 Statesville NC 28687-1845 |
| Practice Telephone | 7048737250 |
| Practice Fax Number | 7048381544 |
| Mailing Telephone | 7048734277 |
| Mailing Fax Number | 7049783549 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
32606 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8928437 | 05 |
| Street Address |
633 BROOKDALE DR STE 100 |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28677-3471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366434862 | Ray I Georgeson | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2005-08-19 |
| 1346882305 | Celeste Stevens | Registered Nurse | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2019-10-11 |
| 1124679402 | Landry Schofield | Nurse Practitioner | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2019-09-26 |
| 1841783735 | Piedmont Healthcare, Pa | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2018-06-14 |
| 1699181651 | Kera Cosper Mondez | Nurse Practitioner | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2014-07-10 |
| 1508137977 | Jips John Zachariah | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2012-01-18 |
| 1285926741 | Denise Groh Criss | Physician Assistant | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2011-05-03 |
| 1356304471 | Janice M. Clayton | Nurse Practitioner | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2006-04-10 |
| 1477548345 | Duncan A Mccall | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2005-09-15 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306081302 | Novant Medical Group, Inc. | Internal Medicine | 349 Brookdale Dr, Statesville, NC 28677-4103 | 2008-12-05 |
| 1669464160 | Keith A Gatlin | Internal Medicine | 766 Hartness Rd, Statesville, NC 28677-3425 | 2005-08-19 |
| 1366434862 | Ray I Georgeson | Internal Medicine | 633 Brookdale Dr Ste 100, Statesville, NC 28677-3471 | 2005-08-19 |
| 1235121997 | John J. Allan | Internal Medicine | 1424 Fern Creek Dr, Suite D, Statesville, NC 28625-9376 | 2005-08-18 |
| 1649636085 | Regional Physicians LLC | Internal Medicine | 218 Old Mocksville Rd, Statesville, NC 28625-1930 | 2016-01-14 |
| 1275914046 | Cornerstone Health Care Pa | Internal Medicine | 218 Old Mocksville Rd, Statesville, NC 28625-1930 | 2015-06-17 |
| 1497031314 | Statesville Hma Medical Group, LLC | Internal Medicine | 349 Brookdale Dr, Statesville, NC 28677-4103 | 2011-10-24 |
| 1235410960 | Iredell Physician Network LLC | Internal Medicine | 738 Bryant St Ste A, Statesville, NC 28677-4189 | 2011-09-08 |
| 1114032398 | James Hedrick Bradford | Internal Medicine | 738 Bryant St, Suite A, Statesville, NC 28677-4189 | 2006-08-20 |
| 1932214137 | Naim Ezzat Bouhussein | Internal Medicine | 738 Bryant St, Suite A, Statesville, NC 28677-4189 | 2006-08-20 |
| 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.