Charles Gray Shore (NPI# 1932486222, PAC ID# 6901071158) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1932486222 |
| PAC ID by PECOS | 6901071158 |
| Professional Enrollment ID | I20111216000141 |
| Full Name | Charles Gray Shore |
| Organization Legal Name | LIFE LINE COMMUNITY HEALTHCARE |
| Address |
11220 Elm Ln Suite 202 Charlotte NC 28277-0450 |
| Phone Number | 8669643285 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7416170501 |
| Number of Group Practice Members | 60 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1616 Westgate Cir, Suite 317, Brentwood, TN 37027-8571 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| 11220 Elm Ln, Suite 202, Charlotte, NC 28277-0450 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| 1156 Bowman Rd, Unit 200, Mount Pleasant, SC 29464-3858 | 8669643285 | LIFE LINE COMMUNITY HEALTHCARE |
| 1518 Willow Lawn Dr, Richmond, VA 23230-3419 | 8665795103 | LIFE LINE COMMUNITY HEALTHCARE |
| Organization Legal Name | LIFE LINE COMMUNITY HEALTHCARE |
| Physicians | 95 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ciara L Eatmon | Nurse Practitioner | Life Line Community Healthcare | 625 Kenmoor Ave Se, Suite 301, Grand Rapids, MI 49546-2395 |
| Sharon Lee Morris | Nurse Practitioner | Life Line Community Healthcare | 309 Court Ave, Suite 816, Des Moines, IA 50309-2282 |
| Laura Ann Rogers | Nurse Practitioner | Life Line Community Healthcare | 400 Chesterfield Ctr, Suite 400, Chesterfield, MO 63017-4800 |
| Marian Anne Ferguson | Nurse Practitioner | Life Line Community Healthcare | 1518 Willow Lawn Dr, Richmond, VA 23230-3419 |
| Wendy Ann Lunny | Nurse Practitioner | Life Line Community Healthcare | 615 W Johnson Ave, Cheshire, CT 06410-4532 |
| Laurie Eastwood Raher | Nurse Practitioner | Life Line Community Healthcare | 7455 Arroyo Crossing Pkwy, Suite 220, Las Vegas, NV 89113-4088 |
| Grace D Ortega-walker | Nurse Practitioner | Life Line Community Healthcare | 109 E 17th St, Suite 4984, Cheyenne, WY 82001-4543 |
| Deirdre Lott | Nurse Practitioner | Life Line Community Healthcare | 406 S Boulder Ave, Suite 400, Tulsa, OK 74103-3800 |
| Shimmy Manoj | Nurse Practitioner | Life Line Community Healthcare | 1655 S Blue Island Ave, Suite 361, Chicago, IL 60608-2133 |
| Bryn Miller | Nurse Practitioner | Life Line Community Healthcare | 6111 Oak Tree Blvd, Suite 301, Independence, OH 44131-2589 |
| Street Address |
11220 ELM LN SUITE 202 |
| City | CHARLOTTE |
| State | NC |
| Zip | 28277-0450 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tabitha L Alford | Nurse Practitioner | Life Line Community Healthcare | 11220 Elm Ln, Suite 202, Charlotte, NC 28277-0450 |
| Sharon K Kanelos | Physical Medicine and Rehabilitation | Integra Rehabilitation Physicians Pllc | 11220 Elm Ln, Suite 102, Charlotte, NC 28277-0716 |
| Bethany J Sprague | Nurse Practitioner | Integra Rehabilitation Physicians Pllc | 11220 Elm Ln, Suite 102, Charlotte, NC 28277-0716 |
| James K Liu | Cardiovascular Disease (cardiology) | 11220 Elm Ln, Suite 200, Charlotte, NC 28277-0450 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica B Bell | Nurse Practitioner | Novant Medical Group Inc | 14215 Ballantyne Corp Pl, Suite 230, Charlotte, NC 28277 |
| Mary M Cummins | Physician Assistant | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| James L Seward | Dermatology | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Keri Anne Squittieri | Physician Assistant | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Elizabeth G Grattan | Dermatology | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Jocelyn E Larocque | Dermatology | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Lisa Michelle Matuga | Physician Assistant | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Lesslie A Marquez-durst | Physician Assistant | Dermatology Care of Charlotte Pa | 15830 Ballantyne Med Pl, Suite 100, Charlotte, NC 28277 |
| Jeffrey A Seegers | Physician Assistant | Carolina Family Healthcare, Pa | 11220 Elm Lane, Suite 102, Charlotte, NC 28277-0716 |
| Dino Peter Kanelos | Family Medicine | Carolina Family Healthcare, Pa | 11220 Elm Lane, Suite 102, Charlotte, NC 28277-0716 |
| Find all physicians in zip 28277 | |||
| City | CHARLOTTE |
| Zip Code | 28277 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CHARLOTTE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Charles Gray Shore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.