SHOCKWAVE SPECIALISTS OF THE CAROLINAS LLC (NPI# 1063446961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063446961 |
| Entity Type | Organization |
| Organization Name | SHOCKWAVE SPECIALISTS OF THE CAROLINAS LLC |
| Practice Address |
705 Griffith St Ste 205 Davidson NC 28036 |
| Mailing Address |
Po Box 30428 Charlotte NC 28230 |
| Practice Telephone | 7048971024 |
| Practice Fax Number | 7048972033 |
| Mailing Telephone | 7048971024 |
| Mailing Fax Number | 7048972033 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. M FILMORE HODNETT (BUSINESS MANAGER) |
| Authorized Official Telephone | 7048972031 |
| Authorized Official Credential | MBA CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
00000 | NC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 014GA | 01 |
| Street Address |
705 GRIFFITH ST STE 205 |
| City | DAVIDSON |
| State | NC |
| Zip Code | 28036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326022633 | Susan Kitchens Wolding | Physical Therapist | 705 Griffith St, Suite 206, Davidson, NC 28036-9304 | 2005-11-30 |
| 1114455128 | Elizabeth Ann Ricciani | Registered Nurse | 705 Griffith St, Davidson, NC 28036-9304 | 2017-06-03 |
| 1902333552 | Ryan Corbello | Family Medicine | 705 Griffith St, Ste 100, Davidson, NC 28036-9304 | 2017-05-15 |
| 1043601768 | Carolinas Physicians Network Inc | Internal Medicine | 705 Griffith St, Ste 100b, Davidson, NC 28036-9304 | 2015-02-17 |
| 1245669308 | Yordan Ascanio | Physical Therapist | 705 Griffith St, Suite 206, Davidson, NC 28036-9304 | 2013-11-08 |
| 1912336645 | Julia Rogers | Nurse Practitioner | 705 Griffith St, Ste 100b, Davidson, NC 28036-9304 | 2013-11-04 |
| 1588924856 | Angela Vandegrift | Pediatrics | 705 Griffith St, Ste 100, Davidson, NC 28036-9304 | 2012-05-21 |
| 1508090978 | Emily Johnson | Physician Assistant | 705 Griffith St, Ste 100, Davidson, NC 28036-9304 | 2009-05-13 |
| 1104067040 | Candace Howell | Pediatrics | 705 Griffith St, Ste 100, Davidson, NC 28036-9304 | 2009-03-23 |
| 1437318318 | Sabrina Kimrey | Pediatrics | 705 Griffith St, Suite 100, Davidson, NC 28036-9304 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851825285 | Samuel Kelse Hughes | Family Medicine | 104 Knox Ct, Suite 100, Davidson, NC 28036 | 2017-04-12 |
| 1023552098 | Melissa Marie Switek | Counselor | 706 Northeast Dr Ste 1, Davidson, NC 28036 | 2016-12-11 |
| 1386016020 | Morgan Rodgers | Counselor | 901 Northeast Drive, Suite 201, Davidson, NC 28036 | 2015-10-21 |
| 1578931333 | Renee Shull Johnson | Counselor | 709 Northeast Dr Ste 22, Davidson, NC 28036 | 2015-09-10 |
| 1356748651 | Terri Ellerbe-graves | Counselor | 505 Park Avenue, Apt 2, Davidson, NC 28036 | 2014-12-02 |
| 1588085609 | Jay Alexander Caskey | Counselor | 16745 Davidson-concord Road, Davidson, NC 28036 | 2013-12-16 |
| 1932443181 | Jeannine Bodner | Social Worker | 120d S Village Ln, Davidson, NC 28036 | 2012-11-11 |
| 1295083921 | Kelley Cock | Counselor | 209 Delburg Street, Suite 103, Davidson, NC 28036 | 2012-08-28 |
| 1922371319 | Healing Tree Counseling and Wellness, Pllc | Counselor | 911 Northeast Drive, 301, Davidson, NC 28036 | 2012-02-15 |
| 1750678470 | Kimberly Makuch Leppert | Social Worker | 432 S. Main St, Suite 200, Davidson, NC 28036 | 2011-07-01 |
| Find all providers in zip 28036 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696834 | Instride Foot & Ankle Specialists, Pllc | Podiatrist | 6341 Cook Ave Ste A, Clemmons, NC 27012-9380 | 2020-07-15 |
| 1497376370 | Carolina Foot & Ankle of Huntersville, PC | Podiatrist | 10310 Couloak Dr Ste 200, Charlotte, NC 28216-7673 | 2020-05-01 |
| 1346861614 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 1506 E Franklin St Ste 104, Chapel Hill, NC 27514-2825 | 2020-04-28 |
| 1316576283 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 3800 Highway 49 South, Harrisburg, NC 28075 | 2020-04-03 |
| 1346878410 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 16419 Northcross Dr Ste A, Huntersville, NC 28078-5009 | 2020-04-01 |
| 1386289841 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 700 Tilghman Dr Ste 722, Dunn, NC 28334-5519 | 2019-11-08 |
| 1881244168 | Unc Physicians Network Group Practices, LLC | Podiatrist | 1505 Sw Cary Pkwy Ste 200, Cary, NC 27511-6219 | 2019-09-18 |
| 1669022950 | Unc Physicians Network Group Practices, LLC | Podiatrist | 501 Health Park Dr Ste 180, Garner, NC 27529-7051 | 2019-09-18 |
| 1861042152 | Unc Physicians Network Group Practices, LLC | Podiatrist | 6602 Knightdale Blvd Ste 203, Knightdale, NC 27545-6567 | 2019-09-18 |
| 1326518630 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 114 N Northwood St, Wallace, NC 28466 | 2018-11-29 |
| Find all providers with the same taxonomy | ||||
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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.