SHELBY SURGICAL ASSOCIATES, PA (NPI# 1861580664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861580664 |
| Entity Type | Organization |
| Organization Name | SHELBY SURGICAL ASSOCIATES, PA |
| Other Organization Name | KINGS MOUNTAIN SURGICAL ASSOICATES, PA |
| Practice Address |
200 W Grover St Shelby NC 28150-3708 |
| Practice Telephone | 7044878591 |
| Practice Fax Number | 7044809726 |
| Mailing Telephone | 7044878591 |
| Mailing Fax Number | 7044809726 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HARRY DOUGLAS HOBSON (PRESIDENT) |
| Authorized Official Telephone | 7044878591 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 39421 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8902656 | 05 | |
| NC | BLUE CROSS BLUE SHILED | 02656 | 01 |
| Other Name | Type Code |
|---|---|
| Kings Mountain Surgical Assoicates, PA | Doing Business As Name - Organization |
| Street Address |
200 W GROVER ST |
| City | SHELBY |
| State | NC |
| Zip Code | 28150-3708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699753251 | Robert Laney IIi | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-01-04 |
| 1821469735 | Carolinas Physicians Network Inc | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2015-10-19 |
| 1255683405 | Wendy England | Nurse Practitioner | 200 W Grover St, Shelby, NC 28150-3708 | 2012-10-12 |
| 1730449273 | Jiselle Marie Bock | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2012-05-17 |
| 1164795845 | Kellie Vanhoy | Physician Assistant | 200 W Grover St, Shelby, NC 28150-3708 | 2012-02-10 |
| 1639464720 | Amanda Eckenrode | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-06-16 |
| 1538452610 | Tamera Cox | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-05-23 |
| 1508185604 | Stephen Von | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2010-05-28 |
| 1245498013 | Joseph Smith | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2008-05-29 |
| 1295781136 | James M Potts | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154981652 | Benjamin Caple | Dentist | 139 W Ross Grove Rd, Shelby, NC 28150 | 2019-06-17 |
| 1003471103 | Anne Marie Lackey | Physician Assistant | 215 Stacey Street, Lawndale, NC 28150 | 2019-05-03 |
| 1174001937 | Allstate Medical Equipment & Supplies | Durable Medical Equipment & Medical Supplies | 607 W Grover St, Shelby, NC 28150 | 2018-08-03 |
| 1013494970 | Shannon Bumgardner Standish | Nurse Practitioner | 1019 N Lafayette Street, Suite 1, Shelby, NC 28150 | 2018-07-24 |
| 1205323078 | Focused Care, Inc | Community/Behavioral Health | 834 Churchill Dr, Shelby, NC 28150 | 2018-04-17 |
| 1508373507 | Janelle Marie Velasco | Acupuncturist | 115 E Sumter St, Shelby, NC 28150 | 2017-12-29 |
| 1902344666 | Georgette Johnson | Durable Medical Equipment & Medical Supplies | 607 West Grover Street, Shelby, NC 28150 | 2017-02-02 |
| 1457703126 | Sweet Caroline Assisted Living LLC | Assisted Living Facility | 110 Greene Drive, Shelby, NC 28150 | 2016-07-06 |
| 1972954113 | Self Determination, LLC | Community Based Residential Treatment Facility, Mental Illness | 423 Millsap Rd, Shelby, NC 28150 | 2016-06-29 |
| 1306217666 | Living Family Supportive Services | Clinic/Center | 2538 West Dixon Blvd., Shelby, NC 28150 | 2015-10-13 |
| Find all providers in zip 28150 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699753251 | Robert Laney IIi | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-01-04 |
| 1821469735 | Carolinas Physicians Network Inc | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2015-10-19 |
| 1700201712 | Mercy Health Partners | Surgery | 71 Bevier St, Shelby, MI 49455-1209 | 2014-02-27 |
| 1730449273 | Jiselle Marie Bock | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2012-05-17 |
| 1639464720 | Amanda Eckenrode | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-06-16 |
| 1538452610 | Tamera Cox | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-05-23 |
| 1508185604 | Stephen Von | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2010-05-28 |
| 1245498013 | Joseph Smith | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2008-05-29 |
| 1295781136 | James M Potts | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-05-25 |
| 1639157290 | Andrew Taylor | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-01-04 |
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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.