Cody E Homistek (NPI# 1306292669, PAC ID# 7911288626) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1306292669 |
| PAC ID by PECOS | 7911288626 |
| Professional Enrollment ID | I20190515000792 |
| Full Name | Cody E Homistek |
| Organization Legal Name | HOLSTON MEDICAL GROUP PC |
| Address |
123 Professional Park Dr Suite 200 Mooresville NC 28117-5519 |
| Phone Number | 4233437016 |
| Gender | M |
| Medical School | WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8224935754 |
| Number of Group Practice Members | 229 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340129 | LAKE NORMAN REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10826 Mallard Creek Rd, Suite 200, Charlotte, NC 28262-9725 | 4233437034 | HOLSTON MEDICAL GROUP PC |
| 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 | 4233437016 | HOLSTON MEDICAL GROUP PC |
| Organization Legal Name | HOLSTON MEDICAL GROUP PC |
| Physicians | 239 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary C Axelrad | Family Medicine | Holston Medical Group PC | 4848 Fort Henry Dr, Kingsport, TN 37663-3347 |
| Jeffrey Richard Many | Family Medicine | Holston Medical Group PC | 275 N Nc 16 Business Hwy, Suite 103, Denver, NC 28037-3008 |
| Connie Rutledge | Nurse Practitioner | Holston Medical Group PC | 1754 Us Hwy 23 N, Weber City, VA 24290-7071 |
| Brandi N Adams | Obstetrics/gynecology | Holston Medical Group PC | 10826 Mallard Creek Rd, Suite 200, Charlotte, NC 28262-9725 |
| Kevin Wess | Family Medicine | Holston Medical Group PC | 4675 Redbud Hwy, Honaker, VA 24260-8004 |
| Shannon M Butler | Nurse Practitioner | Holston Medical Group PC | 9611 Sherrill Estates Rd, Suite B, Huntersville, NC 28078-6485 |
| Julie M Wentz | Family Medicine | Holston Medical Group PC | 9816 Sam Furr Rd, Suite 101, Huntersville, NC 28078-5042 |
| Kenyon L Draper | Nurse Practitioner | Holston Medical Group PC | 3500 Mount Holly Huntersville Rd, Suite B, Charlotte, NC 28216-8644 |
| Nancy E Deem | Nurse Practitioner | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Jennifer Shafer | Family Medicine | Holston Medical Group PC | 2033 Meadowview Ln, Suite 200, Kingsport, TN 37660-7432 |
| Street Address |
123 PROFESSIONAL PARK DR SUITE 200 |
| City | MOORESVILLE |
| State | NC |
| Zip | 28117-5519 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy E Deem | Nurse Practitioner | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Monica L Webb | Physician Assistant | Mooresville Ppm LLC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Rebecca M Panuski | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Bruce S Mather | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Elisabeth E Stoffel | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Stephanie B Elkins | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Caitlin Rowe Goodman | Physician Assistant | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| James E Cook | Physical Therapy | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Thomas M Sherrill | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| David M Cook | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven G Folstad | Emergency Medicine | Carolina Vein Associates Pllc | 206 Joe V Knox Ave H, Mooresville, NC 28117 |
| Paul C Davis | Chiropractic | 514 Williamson Rd, Suite 411, Mooresville, NC 28117-3382 | |
| Gregory Ott | Physical Therapy | Greg Otts Center for Physical Therapy and Sports Performance LLC | 156 Byers Creek Rd, Mooresville, NC 28117-4376 |
| Heather J Osborne | Physical Therapy | Greg Otts Center for Physical Therapy and Sports Performance LLC | 156 Byers Creek Rd, Mooresville, NC 28117-4376 |
| Robert C Monson Iii | Optometry | 125 Commerce Park Rd, Suite 103, Mooresville, NC 28117-4818 | |
| Jennifer A Gartland | Registered Dietitian Or Nutrition Professional | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Donna J Marinelli | Nurse Practitioner | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Anna L Claugus | Family Medicine | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Vinita W Deshpande | Physical Therapy | Holston Medical Group PC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| David L Gish | General Surgery | Mooresville Ppm LLC | 123 Professional Park Dr, Suite 200, Mooresville, NC 28117-5519 |
| Find all physicians in zip 28117 | |||
| City | MOORESVILLE |
| Zip Code | 28117 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MOORESVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Cody E Homistek.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.