MODERN MEDICAL GROUP PLLC (NPI# 1861051591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861051591 |
| Entity Type | Organization |
| Organization Name | MODERN MEDICAL GROUP PLLC |
| Practice Address |
936 Cox Rd Ste A Gastonia NC 28054-3456 |
| Mailing Address |
10619 Trolley Run Dr Cornelius NC 28031-8303 |
| Practice Telephone | 7044979544 |
| Mailing Telephone | 7044979544 |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |
| Authorized Official Name | IVETTE CINTRON-CUBERO (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7044979544 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 56545-1730570136 | 05 |
| Street Address |
936 COX RD STE A |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-3456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| 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 |
|---|---|---|---|---|
| 1578080826 | Carolinas Physicians Network Inc | Family Medicine | 181 S South St, Gastonia, NC 28052-4126 | 2017-08-28 |
| 1437570504 | Leanne Rutledge King | Family Medicine | 1895 Hoffman Rd, Suite B, Gastonia, NC 28054-6557 | 2013-12-17 |
| 1538501903 | Carolina Pediatric Center, Pllc | Family Medicine | 239 Wilmot Dr, Gastonia, NC 28054-4048 | 2013-07-25 |
| 1285940445 | Caromont Medical Group Inc | Family Medicine | 3845 S. New Hope Rd, Gastonia, NC 28056-8439 | 2010-08-26 |
| 1295975910 | Randy Steven Adams | Family Medicine | 5456 Spindle Ridge Ln, Gastonia, NC 28056-8515 | 2009-02-21 |
| 1982883583 | Caromont Medical Group Inc | Family Medicine | 1895 Hoffman Road, Suite A, Gastonia, NC 28054-6557 | 2007-10-31 |
| 1952580557 | Caromont Medical Group Inc | Family Medicine | 4235 S. New Hope Road, Suite A, Gastonia, NC 28056-8453 | 2007-10-31 |
| 1417021254 | Gary Scott Schenk Sr. | Family Medicine | 1381 E Garrison Blvd, Gastonia, NC 28054-5127 | 2006-11-20 |
| 1134235369 | Cornelius S Okonkwo | Family Medicine | 2101 W Franklin Blvd, Gastonia, NC 28052-1338 | 2006-08-21 |
| 1033141114 | Michelle E Wilkinson | Family Medicine | 3302 S New Hope Rd Ste 100e, Gastonia, NC 28056-8317 | 2006-07-07 |
| Find all providers in GASTONIA | ||||
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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.