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721 Grove St Salisbury NC 28144-3339 | |
(252) 702-0267 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 721 Grove St, Salisbury, North Carolina |
Authorized Official Name and Position | Pamela H Tucker (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 3362108409 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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721 Grove St Salisbury NC 28144-3339 Ph: (704) 216-1263 | 721 Grove St Salisbury NC 28144-3339 Ph: (252) 702-0267 |
NPI Number | 1275291361 |
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Provider Enumeration Date | 12/06/2021 |
Last Update Date | 10/18/2023 |
Medicare PECOS PAC ID | 1951784933 |
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Medicare Enrollment ID | O20220824001984 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275291361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kathryn Lesiewicz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831182724 PECOS PAC ID: 1254319973 Enrollment ID: I20081202000595 |
Provider Name | John D Bream |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1811124266 PECOS PAC ID: 4385814177 Enrollment ID: I20110906000270 |
Provider Name | Julane Chappell Upton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629328190 PECOS PAC ID: 9638322068 Enrollment ID: I20130114000370 |
Provider Name | Erin M Lafferty |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740619550 PECOS PAC ID: 3678794534 Enrollment ID: I20141020000588 |
Provider Name | Heather Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952786683 PECOS PAC ID: 1951605369 Enrollment ID: I20160603001280 |
Provider Name | Robert James Jordan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336725050 PECOS PAC ID: 3870993637 Enrollment ID: I20210616000014 |
Provider Name | Amber Dickerson Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780262311 PECOS PAC ID: 1456746627 Enrollment ID: I20220325000376 |
Provider Name | Elizabeth J Fox |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669299210 PECOS PAC ID: 3577099381 Enrollment ID: I20241203004647 |
Copperfield Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Mocksville Ave, Salisbury, NC 28144 Phone: 704-633-7220 Fax: 704-647-0515 | |