| Mooresville Ppm Llc | |
|
131 Medical Park Rd Suite 302 Mooresville NC 28117-8522 | |
| (704) 660-4750 | |
| Not Available |
| Full Name | Mooresville Ppm Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 131 Medical Park Rd, Mooresville, North Carolina |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBOARDING) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mooresville Ppm Llc 4000 Meridian Blvd Franklin TN 37067-6325 Ph: (615) 465-7000 | Mooresville Ppm Llc 131 Medical Park Rd Suite 302 Mooresville NC 28117-8522 Ph: (704) 660-4750 |
| NPI Number | 1700028982 |
|---|---|
| Provider Enumeration Date | 04/02/2009 |
| Last Update Date | 01/14/2022 |
| Medicare PECOS PAC ID | 3577614791 |
|---|---|
| Medicare Enrollment ID | O20090630000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700028982 | NPI | - | NPPES |
| Provider Name | Ronald C Huffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730182957 PECOS PAC ID: 4688666332 Enrollment ID: I20040401000821 |
| Provider Name | Carl A Foulks |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902898562 PECOS PAC ID: 2365432028 Enrollment ID: I20040514000370 |
| Provider Name | Cuong Peter Le |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750340014 PECOS PAC ID: 0143289199 Enrollment ID: I20041006000683 |
| Provider Name | Jan G Pickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598702896 PECOS PAC ID: 3072561034 Enrollment ID: I20050106000073 |
| Provider Name | Peyton W Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912982232 PECOS PAC ID: 0547213886 Enrollment ID: I20050225000665 |
| Provider Name | James B Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760474423 PECOS PAC ID: 9335193895 Enrollment ID: I20050308000466 |
| Provider Name | John Cedarholm |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356353379 PECOS PAC ID: 9537051644 Enrollment ID: I20050311000270 |
| Provider Name | Benjamin Kunesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477524148 PECOS PAC ID: 1254345275 Enrollment ID: I20060130000467 |
| Provider Name | Ronald T Uszenski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447230099 PECOS PAC ID: 1355353665 Enrollment ID: I20060703000100 |
| Provider Name | Timothy R Heider |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245275072 PECOS PAC ID: 9638174667 Enrollment ID: I20060926000591 |
| Provider Name | John Lyle Mcguinness |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639263759 PECOS PAC ID: 0749289965 Enrollment ID: I20061215000151 |
| Provider Name | Leanna J Worsham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528177383 PECOS PAC ID: 8123028966 Enrollment ID: I20070102000122 |
| Provider Name | Karen J Lessaris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619900206 PECOS PAC ID: 7012919905 Enrollment ID: I20070206000230 |
| Provider Name | David L Gish |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821073149 PECOS PAC ID: 5395840607 Enrollment ID: I20070416000277 |
| Provider Name | Michelle M Bertsch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194700419 PECOS PAC ID: 7113022435 Enrollment ID: I20070416000362 |
| Provider Name | Laura Nickles Reniker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710910385 PECOS PAC ID: 2668577669 Enrollment ID: I20070419000672 |
| Provider Name | Doris L Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891914644 PECOS PAC ID: 2365526787 Enrollment ID: I20080225000328 |
| Provider Name | Allyson J Yanni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497713093 PECOS PAC ID: 3072691427 Enrollment ID: I20080424000736 |
| Provider Name | William R Doheny |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194741991 PECOS PAC ID: 5698854974 Enrollment ID: I20080512000581 |
| Provider Name | Twilla M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770756512 PECOS PAC ID: 8628148764 Enrollment ID: I20080602000700 |
| Provider Name | Thomas E Gross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073568283 PECOS PAC ID: 9537236856 Enrollment ID: I20080927000209 |
| Provider Name | Michaela E Renich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841229127 PECOS PAC ID: 8527135847 Enrollment ID: I20080927000217 |
| Provider Name | Ben J Garrido |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558549790 PECOS PAC ID: 5698848208 Enrollment ID: I20091023000617 |
| Provider Name | Kevin C Addison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295750651 PECOS PAC ID: 1557361490 Enrollment ID: I20100512000066 |
| Provider Name | Nikhil Balakrishnan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396993184 PECOS PAC ID: 3870627953 Enrollment ID: I20100811000164 |
| Provider Name | John Carl Clements |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881612364 PECOS PAC ID: 6204930712 Enrollment ID: I20110209000793 |
| Provider Name | Mario A Rojas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326122425 PECOS PAC ID: 0547218737 Enrollment ID: I20111027000464 |
| Provider Name | Emily Rose Mcauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205154952 PECOS PAC ID: 7810145026 Enrollment ID: I20120913000155 |
| Provider Name | Andrew Francis Leigh Gross |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730322843 PECOS PAC ID: 4486895224 Enrollment ID: I20141006000344 |
| Provider Name | Michael Salter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841553864 PECOS PAC ID: 5395050629 Enrollment ID: I20150817000909 |
| Provider Name | Erin Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003267469 PECOS PAC ID: 0941595037 Enrollment ID: I20160829001908 |
| Provider Name | Matthew R Cirullo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770924516 PECOS PAC ID: 7810126406 Enrollment ID: I20160930000257 |
| Provider Name | Samuel E Inkumsah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629242490 PECOS PAC ID: 2668542424 Enrollment ID: I20161014000002 |
| Provider Name | Wayne Edward Stillick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457344285 PECOS PAC ID: 0749464204 Enrollment ID: I20161107000171 |
| Provider Name | Amy N Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306371521 PECOS PAC ID: 6709154289 Enrollment ID: I20170626001802 |
| Provider Name | Jordan Michael Glaser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194058404 PECOS PAC ID: 7810204732 Enrollment ID: I20170918003020 |
| Provider Name | Emily F Carper |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194162891 PECOS PAC ID: 6507131372 Enrollment ID: I20171004000842 |
| Provider Name | Elizabeth Rudisill Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023522281 PECOS PAC ID: 7719248053 Enrollment ID: I20180228001808 |
| Provider Name | Meredith A Harkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770082026 PECOS PAC ID: 3678829090 Enrollment ID: I20180627001834 |
| Provider Name | Lauze Rozan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194934992 PECOS PAC ID: 8123217601 Enrollment ID: I20191210001398 |
| Provider Name | Amber Hicks-thibodeau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063869469 PECOS PAC ID: 1951691575 Enrollment ID: I20200615002723 |
| Provider Name | Kristen Colarell Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245829456 PECOS PAC ID: 8426461237 Enrollment ID: I20210114002239 |
| Provider Name | Malcolm Symes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477040277 PECOS PAC ID: 5496150609 Enrollment ID: I20210826001970 |
| Provider Name | Deborah Ann Neyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467020297 PECOS PAC ID: 9830596394 Enrollment ID: I20210926000007 |
| Provider Name | Nicole Gyasi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396239455 PECOS PAC ID: 9830448588 Enrollment ID: I20211117002829 |
| Provider Name | Jamie Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265041602 PECOS PAC ID: 8426448481 Enrollment ID: I20211206001674 |
| Provider Name | Leslie Fulton Nakhle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952972283 PECOS PAC ID: 2961895552 Enrollment ID: I20220202002811 |
| Provider Name | Jehon Amen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336600121 PECOS PAC ID: 5890171011 Enrollment ID: I20220926001702 |
| Provider Name | Creighton Fiscina |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487801957 PECOS PAC ID: 1052556420 Enrollment ID: I20221004000552 |
| Provider Name | Brooke Star Colombero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740990050 PECOS PAC ID: 0042681389 Enrollment ID: I20230124000835 |
| Provider Name | Kimberly Auci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518741149 PECOS PAC ID: 5496100083 Enrollment ID: I20231017003576 |
| Provider Name | Khaled Mansour |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1427281641 PECOS PAC ID: 7214226505 Enrollment ID: I20240409004963 |
Iredell Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 143 Joe Knox Ave, Suite 100, Mooresville, NC 28117 Phone: 704-878-4500 Fax: 704-872-7924 | |
Harbor Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 478 Williamson Rd, Suite B, Mooresville, NC 28117 Phone: 704-660-0321 Fax: 704-660-0765 | |
Wellcomemd Nc Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 Kilson Dr Ste 201, Mooresville, NC 28117 Phone: 704-444-0999 Fax: 980-498-7007 | |
Greenbrook Tms Mooresville Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 149 Plantation Ridge Dr Ste 150, Mooresville, NC 28117 Phone: 855-910-4867 Fax: 855-920-4867 | |
My Health Center At Lowe's Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Lowes Blvd, Mooresville, NC 28117 Phone: 704-758-2000 Fax: 704-757-0510 | |
Stout Internal Medicine & Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 544 Brawley School Rd, Suite C, Mooresville, NC 28117 Phone: 704-360-9310 | |
Lake Norman Endocrinology & Diabetes, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 143 Joe Knox Ave, Suite 100, Mooresville, NC 28117 Phone: 704-664-2936 |