| Lake Norman Medical, Pllc | |
|
1661 Davie Ave Statesville NC 28677-3519 | |
| (704) 495-2470 | |
| Not Available |
| Full Name | Lake Norman Medical, Pllc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 1661 Davie Ave, Statesville, North Carolina |
| Authorized Official Name and Position | Ronald Adams (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7044952470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Norman Medical, Pllc 1661 Davie Ave Statesville NC 28677-3519 Ph: (704) 495-2470 | Lake Norman Medical, Pllc 1661 Davie Ave Statesville NC 28677-3519 Ph: (704) 495-2470 |
| NPI Number | 1699300822 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 10/26/2021 |
| Medicare PECOS PAC ID | 9335570332 |
|---|---|
| Medicare Enrollment ID | O20200507000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699300822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Harrison Gabriel Frank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518143460 PECOS PAC ID: 1759554298 Enrollment ID: I20111028000603 |
| Provider Name | Hemal V Mehta |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174533772 PECOS PAC ID: 7719935956 Enrollment ID: I20141103000861 |
| Provider Name | Claudia Moulden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427399252 PECOS PAC ID: 2466689120 Enrollment ID: I20141121002101 |
| Provider Name | Stacey C Bohm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508484031 PECOS PAC ID: 6507284684 Enrollment ID: I20200922002614 |
| Provider Name | Michelle Victoria Simonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154916799 PECOS PAC ID: 4183074891 Enrollment ID: I20231221000455 |
Piedmont Healthcare, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 533 Brookdale Dr, Statesville, NC 28677 Phone: 704-838-8249 Fax: 704-495-3057 | |
Nuvu Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Sullivan Rd, Statesville, NC 28677 Phone: 980-434-5426 | |
Sound Physicians Of North Carolina Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 Old Mocksville Rd, Statesville, NC 28625 Phone: 704-873-0281 Fax: 704-838-7287 | |
Piedmont Healthcare, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Gaither Rd, Statesville, NC 28625 Phone: 704-871-1155 Fax: 704-872-2484 | |
Statesville Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Davie Ave, Statesville, NC 28677 Phone: 704-873-3269 Fax: 704-871-8159 | |
Novant Health Primary Care Fern Creek Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1410 Fern Creek Dr, Statesville, NC 28625 Phone: 704-978-2250 Fax: 704-978-2258 | |
Cuong Tan Doan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 557 Brookdale Dr, Statesville, NC 28677 Phone: 800-409-2919 |