| Vitae Health Medical North Carolina, Pllc | |
|
550 Glenwood Dr Mooresville NC 28115-2876 | |
| (224) 777-8034 | |
| (224) 236-4900 |
| Full Name | Vitae Health Medical North Carolina, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 Glenwood Dr, Mooresville, North Carolina |
| Authorized Official Name and Position | Amish M Patel (PRESIDENT) |
| Authorized Official Contact | 2247778034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical North Carolina, Pllc 3450 Oakton St Ste 300 Skokie IL 60076-2951 Ph: (224) 777-8034 | Vitae Health Medical North Carolina, Pllc 550 Glenwood Dr Mooresville NC 28115-2876 Ph: (224) 777-8034 |
| NPI Number | 1265064414 |
|---|---|
| Provider Enumeration Date | 02/06/2020 |
| Last Update Date | 09/30/2021 |
| Medicare PECOS PAC ID | 7719317932 |
|---|---|
| Medicare Enrollment ID | O20200430000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265064414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Eileen M Quilty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891773008 PECOS PAC ID: 6709892250 Enrollment ID: I20060221000882 |
| Provider Name | Helen B Trahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205803103 PECOS PAC ID: 6800996729 Enrollment ID: I20070706000487 |
| Provider Name | Traci Dawn Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306802822 PECOS PAC ID: 8426159054 Enrollment ID: I20070725000681 |
| Provider Name | Kathy K Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083954689 PECOS PAC ID: 2062653934 Enrollment ID: I20130719000210 |
| Provider Name | Teofil L Misaras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710328240 PECOS PAC ID: 2961638762 Enrollment ID: I20131127000951 |
| Provider Name | James M Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093001760 PECOS PAC ID: 5890914196 Enrollment ID: I20140918002256 |
| Provider Name | Nickcola Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992112007 PECOS PAC ID: 1456572916 Enrollment ID: I20141027000254 |
| Provider Name | Andrea D Dominick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407228521 PECOS PAC ID: 7113229105 Enrollment ID: I20160107002251 |
| Provider Name | Megan M Bumgarner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699125070 PECOS PAC ID: 5294022307 Enrollment ID: I20160916001786 |
| Provider Name | Mary Ann Rather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700336054 PECOS PAC ID: 5890083760 Enrollment ID: I20161007001485 |
| Provider Name | Victoria Linda Gay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417491960 PECOS PAC ID: 6901180215 Enrollment ID: I20170306002173 |
| Provider Name | Regina C Ingle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134647571 PECOS PAC ID: 8820364391 Enrollment ID: I20171027001679 |
| Provider Name | Stephanie Gregg Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407399306 PECOS PAC ID: 1850650821 Enrollment ID: I20180119001480 |
| Provider Name | Cesar Nsumanganyi Kalombo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568935039 PECOS PAC ID: 3476892563 Enrollment ID: I20190307001842 |
| Provider Name | Martu Tennih Tamba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124323316 PECOS PAC ID: 7911230313 Enrollment ID: I20190617001742 |
| Provider Name | Nateka Latrice Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558922096 PECOS PAC ID: 4587090576 Enrollment ID: I20200211002156 |
| Provider Name | Amish M Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457502619 PECOS PAC ID: 4082801964 Enrollment ID: I20200430000666 |
| Provider Name | Amanda Shrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922545698 PECOS PAC ID: 8628341641 Enrollment ID: I20200528001909 |
| Provider Name | Ernestine Futrell Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831719376 PECOS PAC ID: 8224451505 Enrollment ID: I20200702002278 |
| Provider Name | Victor D Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861622060 PECOS PAC ID: 8527297381 Enrollment ID: I20200722003650 |
| Provider Name | Latara Craddock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942821152 PECOS PAC ID: 1951721653 Enrollment ID: I20201019002485 |
| Provider Name | Kashari L Fulks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003428293 PECOS PAC ID: 4880004597 Enrollment ID: I20201109002608 |
| Provider Name | Davina Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609475821 PECOS PAC ID: 6709293251 Enrollment ID: I20210329001599 |
| Provider Name | Alan Townes Grizzard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881295418 PECOS PAC ID: 9537577507 Enrollment ID: I20210413001786 |
| Provider Name | Brent Delac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255917423 PECOS PAC ID: 4385052703 Enrollment ID: I20210422002431 |
| Provider Name | Sinobuhle M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851833875 PECOS PAC ID: 9133528755 Enrollment ID: I20210817002770 |
| Provider Name | Vanessa Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235894056 PECOS PAC ID: 6002205523 Enrollment ID: I20211122001872 |
| Provider Name | Carrie Elizabeth Avery Burleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306316179 PECOS PAC ID: 7113266362 Enrollment ID: I20211220000067 |
| Provider Name | Kristin Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912667072 PECOS PAC ID: 6406248558 Enrollment ID: I20220121001421 |
| Provider Name | Lawanda Judge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932696861 PECOS PAC ID: 9133512205 Enrollment ID: I20220214000948 |
| Provider Name | Kristy Mcleod Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265185227 PECOS PAC ID: 2961899703 Enrollment ID: I20220426003162 |
| Provider Name | Kimberly Ann Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699423038 PECOS PAC ID: 0345627592 Enrollment ID: I20220510001099 |
| Provider Name | Lakeisha Marie Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205580131 PECOS PAC ID: 3072996602 Enrollment ID: I20220815003509 |
| Provider Name | Emilia Lee Wunderlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881326718 PECOS PAC ID: 9739562141 Enrollment ID: I20220818000183 |
| Provider Name | Latifah Quanah Jeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184381659 PECOS PAC ID: 3870977960 Enrollment ID: I20220909000235 |
| Provider Name | Afi Nono Kpakossou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497463137 PECOS PAC ID: 7618382193 Enrollment ID: I20230119000494 |
| Provider Name | Sarah Christina Risch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346940707 PECOS PAC ID: 0749645893 Enrollment ID: I20230425002718 |
| Provider Name | Mary Angela Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891840542 PECOS PAC ID: 9234102427 Enrollment ID: I20230801000743 |
| Provider Name | Shean Kelly Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790223923 PECOS PAC ID: 0547604092 Enrollment ID: I20240223000005 |
| Provider Name | Latoyia Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407092117 PECOS PAC ID: 4789020595 Enrollment ID: I20240314001441 |
| Provider Name | Kimatia S Watkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538462254 PECOS PAC ID: 4789021239 Enrollment ID: I20240320002077 |
| Provider Name | Kellie Person |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669896148 PECOS PAC ID: 9234577685 Enrollment ID: I20240403003438 |
| Provider Name | Shandale Dawn Alcorn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144892647 PECOS PAC ID: 4284073776 Enrollment ID: I20240417000249 |
| Provider Name | Anissa Joseph |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962076265 PECOS PAC ID: 6103268156 Enrollment ID: I20240522003841 |
| Provider Name | Ngozi Regina Eze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093410581 PECOS PAC ID: 7911349865 Enrollment ID: I20240523003738 |
| Provider Name | Electre Shemil Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821661422 PECOS PAC ID: 9830531649 Enrollment ID: I20240524001649 |
| Provider Name | Sherry Lynn Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558123323 PECOS PAC ID: 8527400357 Enrollment ID: I20240524002578 |
| Provider Name | Jasmine Reese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225646433 PECOS PAC ID: 7911349287 Enrollment ID: I20240531002627 |
| Provider Name | Macquinton Latroy Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063294445 PECOS PAC ID: 5799227724 Enrollment ID: I20240606000439 |
| Provider Name | Rosario Sralla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033567318 PECOS PAC ID: 1658711619 Enrollment ID: I20240606003427 |
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 |