STATESVILLE HMA MEDICAL GROUP, LLC (NPI# 1013291442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013291442 |
| Entity Type | Organization |
| Organization Name | STATESVILLE HMA MEDICAL GROUP, LLC |
| Other Organization Name | CAROLINA UROLOGY CARE |
| Practice Address |
1424 Fern Creek Dr Suite B Statesville NC 28625-9376 |
| Mailing Address |
5811 Pelican Bay Blvd Suite 500 Naples FL 34108-2733 |
| Practice Telephone | 7046629870 |
| Practice Fax Number | 7046629788 |
| Mailing Telephone | 2395983131 |
| Mailing Fax Number | 2395920438 |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2013-01-29 |
| Authorized Official Name | MR. MICHAEL L GINGRAS (VICE PRESIDENT, PPM) |
| Authorized Official Telephone | 2395983131 |
| Is Organization Subpart | Y |
| Parent Organization Name | HEALTH MANAGEMENT ASSOCIATES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Carolina Urology Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548544984 | Statesville Hma Medical Group, LLC | Surgery | 1703 Davie Ave, Statesville, NC 28677-3521 | 2011-10-04 |
| 1538443973 | Statesville Hma Medical Group, LLC | Psychiatry & Neurology | 1418 Fern Creek Dr, Statesville, NC 28625-9376 | 2011-10-04 |
| 1639407737 | Statesville Hma Medical Group, LLC | Family Medicine | 1412 Fern Creek Dr, Statesville, NC 28625-9376 | 2009-12-01 |
| 1548796584 | Statesville Hma Medical Group, LLC | Family Medicine | 35 Ruritan Park Rd, Stony Point, NC 28678-8928 | 2017-05-11 |
| 1932476298 | Statesville Hma Medical Group, LLC | Urology | 1410 Fern Creek Dr, Statesville, NC 28625-9376 | 2011-11-30 |
| 1801163167 | Statesville Hma Medical Group, LLC | Family Medicine | 1414 Fern Creek Dr, Statesville, NC 28625-9376 | 2011-11-30 |
| 1497031314 | Statesville Hma Medical Group, LLC | Internal Medicine | 349 Brookdale Dr, Statesville, NC 28677-4103 | 2011-10-24 |
| 1629352679 | Statesville Hma Medical Group, LLC | Orthopaedic Surgery | 340 Signal Hill Dr Ste A, Statesville, NC 28625-4483 | 2011-10-07 |
| 1609150655 | Statesville Hma Medical Group, LLC | Orthopaedic Surgery | 223 Hospital St, Mocksville, NC 27028-2038 | 2011-10-07 |
| 1871877829 | Statesville Hma Medical Group, LLC | Physical Therapist | 375 Hospital St, Suite 200, Mocksville, NC 27028-2086 | 2011-10-07 |
| Street Address |
1424 FERN CREEK DR SUITE B |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28625-9376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235121997 | John J. Allan | Internal Medicine | 1424 Fern Creek Dr, Suite D, Statesville, NC 28625-9376 | 2005-08-18 |
| 1215257928 | Drs. Busby & Webb II, P.a. | Dentist | 1424 Fern Creek Dr, C, Statesville, NC 28625-9376 | 2010-06-03 |
| 1770756512 | Twilla Mitchell Walker | Nurse Practitioner | 1424 Fern Creek Dr, Suite D, Statesville, NC 28625-9376 | 2008-04-11 |
| 1235121740 | Robert S Grajewski | Urology | 1424 Fern Creek Dr, Suite B, Statesville, NC 28625-9376 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714163 | Sandra Lourdes Mayta | Counselor | 1450 Fern Creek Drive, Statesville, NC 28625 | 2020-03-05 |
| 1023643582 | Youngchi Chang Dds Pllc | Dentist | 964 Glenway Ave Ste A, Statesville, NC 28625 | 2020-03-05 |
| 1538799200 | Nicole-marie Blischak | Dentist | 964 Glenway Dr, Ste A, Statesville, NC 28625 | 2020-01-22 |
| 1013575257 | Sherry Neilson | Registered Nurse | 524 Signal Hill Rd, Statesville, NC 28625 | 2019-06-03 |
| 1770904328 | Elinor Kyle Tyner | Counselor | 1206 Museum Road, Statesville, NC 28625 | 2013-12-30 |
| 1982031001 | Tamiko Bradley | Counselor | 524 Signal Hill Dr Ext, Statesville, NC 28625 | 2013-10-03 |
| 1487932505 | Nicole Weisner Winecoff | Advanced Practice Midwife | 1420 Fern Creek Drive, Statesville, NC 28625 | 2011-07-22 |
| 1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
| 1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
| 1619122538 | Phasebdevelopment | Substance Abuse Rehabilitation Facility | 113 Bethany Rd, Statesville, NC 28625 | 2008-11-19 |
| Find all providers in zip 28625 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134383870 | Novant Medical Group, Inc. | Urology | 1410 Fern Creek Drive, Statesville, NC 28625-4483 | 2008-07-11 |
| 1508858390 | Carolyn M Coryell | Urology | 730 Hartness Rd, Statesville, NC 28677-3425 | 2005-08-17 |
| 1932476298 | Statesville Hma Medical Group, LLC | Urology | 1410 Fern Creek Dr, Statesville, NC 28625-9376 | 2011-11-30 |
| 1497912018 | Kush Patel | Urology | 208 Old Mocksville Rd, Statesville, NC 28625-1953 | 2008-05-21 |
| 1922086966 | Michael H Schlesinger | Urology | 730 Hartness Rd, Statesville, NC 28677-3425 | 2006-01-09 |
| 1235121740 | Robert S Grajewski | Urology | 1424 Fern Creek Dr, Suite B, Statesville, NC 28625-9376 | 2005-08-19 |
| 1376535823 | Tink A Johnson IIi | Urology | 208 Old Mocksville Rd, Statesville, NC 28625-1930 | 2005-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528673423 | Meredith Abernethy | Urology | 140 Kimel Park Dr # 100, Winston Salem, NC 27103-6184 | 2020-09-09 |
| 1942833678 | Joshua Daniel Howell | Urology | 10650 Park Rd Ste 320, Charlotte, NC 28210-8543 | 2020-02-21 |
| 1144887019 | Shuo Liu | Urology | Department of Urology Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2019-05-25 |
| 1427563725 | Hifu Prostate Services, LLC | Urology | 4108 Park Rd Ste 205, Charlotte, NC 28209-2260 | 2017-12-08 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1184163883 | Dlp Central Carolina Medical Group LLC | Urology | 1139 Carthage St Ste 110-b, Sanford, NC 27330-4111 | 2017-02-15 |
| 1578007225 | Cumberland County Hospital System Inc | Urology | 805 Tilghman Dr, Suite A, Dunn, NC 28334-5887 | 2016-12-15 |
| 1063963080 | Novant Medical Group, Inc | Urology | 1730 Kernersville Medical Pkwy Ste 303, Kernersville, NC 27284-7198 | 2016-10-14 |
| 1588019152 | Murphy Medical Center, Inc. | Urology | 75 Medical Park Ln Ste A, Murphy, NC 28906-6673 | 2016-05-02 |
| 1427446723 | Regional Physicians LLC | Urology | 217- 218 Gatewood Ave, High Point, NC 27262-4877 | 2015-01-08 |
| Find all providers with the same taxonomy | ||||
| City | STATESVILLE |
| Zip Code | 28625 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.