WILLIAM JOHN EDMISTON JR. (NPI# 1053420190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053420190 |
Entity Type | Individual |
Full Name | WILLIAM JOHN EDMISTON JR. |
Credential | MD |
Practice Address |
170 Medical Park Rd Suite 301 Mooresville NC 28117-8540 |
Practice Telephone | 7043604378 |
Practice Fax Number | 7046968150 |
Mailing Telephone | 7043604378 |
Mailing Fax Number | 7046968150 |
Enumeration Date | 2006-08-30 |
Last Update Date | 2013-06-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
200000410 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 891269N | 05 | |
NC | DEA | BE5025487 | 01 |
Street Address |
170 MEDICAL PARK RD SUITE 301 |
City | MOORESVILLE |
State | NC |
Zip Code | 28117-8540 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942205521 | Carmella Gismondi-eagan | Internal Medicine | 170 Medical Park Rd, Ste 140a, Mooresville, NC 28117-8540 | 2005-06-20 |
1851803829 | Anusha Kapadia | Nurse Practitioner | 170 Medical Park Rd, Ste 140a, Mooresville, NC 28117-8540 | 2017-10-31 |
1942667027 | Emily Ventre | Nurse Practitioner | 170 Medical Park Rd, Mooresville, NC 28117 | 2016-01-21 |
1710313796 | Lynn Barrier Barringer | Nurse Practitioner | 170 Medical Park Rd, Mooresville, NC 28117-8540 | 2013-09-23 |
1497032304 | Mooresville Ppm LLC | Orthopaedic Surgery | 170 Medical Park Rd, Suite 102, Mooresville, NC 28117-8540 | 2011-11-05 |
1992003339 | Interventional Pain Management of Lake Norman Pllc | Pain Medicine | 170 Medical Park Rd, Suite 301, Mooresville, NC 28117-8540 | 2011-03-09 |
1245486414 | Novant Medical Group, Inc. | Internal Medicine | 170 Medical Park Rd, Suite 140, Mooresville, NC 28117-8540 | 2008-08-07 |
1811151244 | Carolinas Physicians Network Inc | Internal Medicine | 170 Medical Park Rd, Ste 140a, Mooresville, NC 28117-8540 | 2008-07-15 |
1194914655 | Carolina Spine & Pain Center, Pllc | Pain Medicine | 170 Medical Park Rd, Suite 310, Mooresville, NC 28117-8540 | 2007-10-22 |
1932294717 | Maje D. Goodwin | Pediatrics | 170 Medical Park Rd, Suite 102a, Mooresville, NC 28117 | 2006-10-04 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891356648 | Teleoptometric Service, P.C. | Optometrist | 392 Talbert Rd, Mooresville, NC 28117 | 2019-06-24 |
1992268544 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 392 Talbert Rd., Mooresville, NC 28117 | 2019-04-10 |
1982178042 | Langtree Endoscopy Center, LLC | Clinic/Center | 106 Alexander Bank Drive, Suite 101, Mooresville, NC 28117 | 2019-01-11 |
1679044416 | May and Associates Therapy Center | Psychologist | 862 Brawley School Road, Suite 202, Mooresville, NC 28117 | 2018-12-05 |
1700360153 | Sabrina Chabot Hutchinson | Physical Therapist | 508 Williamson Rd, Suite 200, Mooresville, NC 28117 | 2018-09-21 |
1992284327 | Presbyterian Imaging Centers LLC | Radiology | 106 Langtree Village Dr # 201, Mooresville, NC 28117 | 2018-08-07 |
1073091310 | Jenelle Donzelli Nemeth | Registered Nurse | 102 Sapphire Drive, Mooresville, NC 28117 | 2018-07-30 |
1912497496 | Patsharx LLC | Pharmacy | 480 River Hwy, Suite A, Mooresville, NC 28117 | 2018-05-10 |
1427502434 | Counseling Service At Lake Norman, Pllc | Community/Behavioral Health | 18117 W. Catawba Avenue, Cornelius, NC 28117 | 2016-08-08 |
1447605928 | Renewal Counseling, Pllc | Counselor | 125 Commerce Park Rd., Suite 102, Mooresville, NC 28117 | 2016-05-03 |
Find all providers in zip 28117 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992003339 | Interventional Pain Management of Lake Norman Pllc | Pain Medicine | 170 Medical Park Rd, Suite 301, Mooresville, NC 28117-8540 | 2011-03-09 |
1194914655 | Carolina Spine & Pain Center, Pllc | Pain Medicine | 170 Medical Park Rd, Suite 310, Mooresville, NC 28117-8540 | 2007-10-22 |
1790773000 | Mark C Hines | Pain Medicine | 170 Medical Park Rd, Suite 310, Mooresville, NC 28117-8540 | 2005-10-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306317011 | United Spine & Pain PC | Pain Medicine | 855 Bradley St Ste A, Concord, NC 28025-2979 | 2018-12-07 |
1144604273 | Justis Group of Edenton | Pain Medicine | 905 Cherry St, North Wilkesboro, NC 28659-4251 | 2015-07-18 |
1578968079 | Carolinas Center for Advanced Management of Pain | Pain Medicine | 2569 Pembroke Rd, Gastonia, NC 28054-4712 | 2014-10-27 |
1255351110 | Scott Richard Johnston | Pain Medicine | 250 Huff Dr, Jacksonville, NC 28546-7369 | 2006-07-20 |
1558366385 | Sunil K Arora | Pain Medicine | 1602 Physicians Dr, Suite 103, Wilmington, NC 28401-7363 | 2005-06-17 |
1528063542 | Center for Pain Management Pllc | Pain Medicine | 1602 Physicians Dr Ste 103, Wilmington, NC 28401-7350 | 2005-06-16 |
1992310502 | Southeastern Pain and Wellness, Pllc | Pain Medicine | 402 W King St, King, NC 27021-9170 | 2020-09-10 |
1710592399 | Triangle Pain Institute | Pain Medicine | 2605 Blue Ridge Rd Ste 330, Raleigh, NC 27607-6475 | 2020-09-10 |
1144863358 | Envision Pain Management Pllc | Pain Medicine | 107 Haywood Park Dr, Clyde, NC 28721-4405 | 2019-10-21 |
1518438811 | Medical Innovations Concepts, P.C. | Pain Medicine | 294 N Nc 16 Business Hwy Ste B, Denver, NC 28037-8741 | 2018-12-12 |
Find all providers with the same taxonomy |
City | MOORESVILLE |
Zip Code | 28117 |
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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.