SUBY MAMMEN (NPI# 1578041562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578041562 |
| Entity Type | Individual |
| Full Name | SUBY MAMMEN |
| Credential | NP |
| Practice Address |
2525 Court Dr Gastonia NC 28054-2140 |
| Mailing Address |
3352 Mandrake Ct Tega Cay SC 29708-8806 |
| Practice Telephone | 7048342000 |
| Mailing Telephone | 8033896725 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5010709 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2525 COURT DR |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664098 | Philip George Leone | Specialist | 2525 Court Dr, Gastonia, NC 28054-2140 | 2005-07-26 |
| 1124657564 | Jessica Underwood | Registered Nurse | 2525 Court Dr, Gastonia, NC 28054-2140 | 2020-04-07 |
| 1376182055 | Haley Noelle Devoe | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-12-30 |
| 1376182261 | Nicole Ruth Ann Bolt | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-12-26 |
| 1902441082 | Brennan Yett | Registered Nurse | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-11-12 |
| 1427692227 | Kara P Wilson | Nurse Anesthetist, Certified Registered | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-11-05 |
| 1568013233 | Rebecca Tooley Woodring | Physical Therapist | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-09-24 |
| 1730734989 | Rachel Carnicelli | Physician Assistant | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-08-05 |
| 1477113090 | Mckenzie Bolin Phillips | Nurse Practitioner | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-06-17 |
| 1528623840 | David Salter | Emergency Medicine | 2525 Court Dr, Gastonia, NC 28054-2140 | 2019-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578172748 | Temeshia Lasha Spikes | Nurse Practitioner | 2555 Court Dr Ste 400, Gastonia, NC 28054-2180 | 2020-07-23 |
| 1558994699 | Wayne Edward Lawing | Nurse Practitioner | 1208 E Franklin Blvd Apt H, Gastonia, NC 28054-4259 | 2020-02-18 |
| 1790293223 | Gretchen Theresa Caldwell | Nurse Practitioner | 660 Summit Crossing Pl Ste 306, Gastonia, NC 28054-2183 | 2018-01-18 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1912282674 | Julie Parker Thompson | Nurse Practitioner | 1006 Union Rd, Ste B, Gastonia, NC 28054-5591 | 2011-10-13 |
| 1881905180 | Billie Hsu | Nurse Practitioner | 2908 Audrey Dr, Gastonia, NC 28054-7268 | 2010-07-01 |
| 1033434519 | Lisa Marie Suddreth | Nurse Practitioner | 830 Summit Crossing Pl, Gastonia, NC 28054-2192 | 2010-03-29 |
| 1699824391 | Susan Paulette Payne | Nurse Practitioner | 1723 Armstrong Park Dr, Gastonia, NC 28054-4802 | 2007-01-10 |
| 1003992058 | Susanna M Shepard | Nurse Practitioner | 609 N Highland St, Gastonia, NC 28052-2179 | 2006-10-31 |
| 1629020581 | Donna Gayle Lee | Nurse Practitioner | 1075 E Hudson Blvd, Gastonia, NC 28054-1694 | 2006-05-17 |
| Find all providers in GASTONIA | ||||
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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.