Longevity Accountable Care, Pa | |
635 Statesville Blvd Salisbury NC 28144-2201 | |
(704) 633-7390 | |
Not Available |
Full Name | Longevity Accountable Care, Pa |
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Speciality | Family Medicine |
Location | 635 Statesville Blvd, Salisbury, North Carolina |
Authorized Official Name and Position | Diane Vincur (PRACTICE MANAGER) |
Authorized Official Contact | 5618152427 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Longevity Accountable Care, Pa 11780 Us Highway 1 Ste N107 Palm Beach Gardens FL 33408-3007 Ph: (561) 815-2427 | Longevity Accountable Care, Pa 635 Statesville Blvd Salisbury NC 28144-2201 Ph: (704) 633-7390 |
NPI Number | 1396584454 |
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Provider Enumeration Date | 05/20/2024 |
Last Update Date | 05/20/2024 |
Medicare PECOS PAC ID | 0840734034 |
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Medicare Enrollment ID | O20240718000268 |
Identifier | Type | State | Issuer |
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1396584454 | NPI | - | NPPES |
Provider Name | Ann Hyatt Poplin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740327337 PECOS PAC ID: 1355402660 Enrollment ID: I20081204000963 |
Provider Name | Cynthia Ann Martin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649543745 PECOS PAC ID: 7315107588 Enrollment ID: I20120326000391 |
Provider Name | Sherry L Clark |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952675209 PECOS PAC ID: 4587811633 Enrollment ID: I20140502001869 |
Provider Name | Lashonda H Barnette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639596851 PECOS PAC ID: 0648493106 Enrollment ID: I20140602001251 |
Provider Name | Kimberly Ann Vasiento |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578168134 PECOS PAC ID: 9537572177 Enrollment ID: I20201229000229 |
Provider Name | Marykay Holt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003275199 PECOS PAC ID: 5092011494 Enrollment ID: I20211112000087 |
Provider Name | Renee Donelson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538636477 PECOS PAC ID: 1850630757 Enrollment ID: I20211112000437 |
Provider Name | Michele Knorr |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740717222 PECOS PAC ID: 7911279021 Enrollment ID: I20240806003627 |
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 | |