LIFE ENHANCEMENT MEDICAL SERVICES PLLC (NPI# 1124046198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124046198 |
| Entity Type | Organization |
| Organization Name | LIFE ENHANCEMENT MEDICAL SERVICES PLLC |
| Practice Address |
190 Commerce Blvd Statesville NC 28625-8526 |
| Mailing Address |
2632 Fines Creek Dr Statesville NC 28625-4441 |
| Practice Telephone | 7048380516 |
| Practice Fax Number | 7048380565 |
| Mailing Telephone | 7048380516 |
| Mailing Fax Number | 7048380565 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | RICHARD PAVELOCK (OWNER) |
| Authorized Official Telephone | 7048380516 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5904288 | 05 |
| Street Address |
190 COMMERCE BLVD |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28625-8526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790982841 | Rha Health Services Nc, LLC | Community/Behavioral Health | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2007-07-02 |
| 1235261678 | Rha Health Services Nc, LLC | Community/Behavioral Health | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2007-03-12 |
| 1790817120 | Rha Health Services Nc, LLC | Community/Behavioral Health | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2007-03-12 |
| 1649302076 | Rha Health Services Nc, LLC | Community/Behavioral Health | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2007-03-12 |
| 1154456416 | Rha Health Services Nc, LLC | Community/Behavioral Health | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2007-02-23 |
| 1487739579 | Richard M Pavelock | Specialist | 190 Commerce Blvd, Statesville, NC 28625-8526 | 2006-10-26 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225548597 | Piedmont Healthcare, Pa | Internal Medicine | 276 Old Mocksville Rd Ste 105, Statesville, NC 28625-1950 | 2017-10-02 |
| 1154609147 | Iredell Physician Network LLC | Internal Medicine | 1714 Davie Ave, Statesville, NC 28677-3522 | 2011-07-26 |
| 1861692188 | Charalambos Demetri | Internal Medicine | 142 Sherlock Drive, Statesville, NC 28625-1953 | 2007-07-24 |
| 1497723795 | John Nicholson | Internal Medicine | 728 Hartness Rd, Statesville, NC 28677-3425 | 2006-03-10 |
| 1780663567 | Henry C Walters Jr. | Internal Medicine | 1217 Davie Ave, Statesville, NC 28677-3511 | 2006-01-11 |
| 1194704981 | William Andrew White | Internal Medicine | 517 Brookdale Dr, Statesville, NC 28677-4107 | 2006-01-11 |
| 1861489759 | Willie Roscoe Whitaker | Internal Medicine | 2117 Simonton Rd, Suite 102, Statesville, NC 28625-8403 | 2005-10-05 |
| 1528050184 | James S Foushee | Internal Medicine | 1818 Davie Ave, Statesville, NC 28677-3524 | 2005-08-19 |
| 1477545986 | Roger A Hatharasinghe | Internal Medicine | 138 Sherlock Dr, Statesville, NC 28625-1916 | 2005-08-19 |
| 1245231430 | Mel Voulgaropoulos | Internal Medicine | 1503 E Broad St, Statesville, NC 28625-4301 | 2005-08-10 |
| Find all providers in STATESVILLE | ||||
| 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.