Organization Active NPI

Life Enhancement Medical Services PLLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Statesville, NC
National Provider Identifier
1124046198
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
LIFE ENHANCEMENT MEDICAL SERVICES PLLC
Practice address
2632 Fines Creek Dr
Statesville, NC 28625-4441
Phone
(704) 880-8665
Fax
(704) 838-0565
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Pavelock, MD
Title
Owner
Phone
(704) 838-0516

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X Primary

Addresses

Primary practice location

2632 Fines Creek Dr
Statesville, NC 28625-4441

Mailing address

2632 Fines Creek Dr
Statesville, NC 28625-4441
Phone (704) 838-0516

Other identifiers 1

IdentifierTypeStateIssuer
5904288MedicaidNC

National Provider Directory

National Provider Directory

Locations

28 Pisgah View Ave
Asheville, NC 28803
Phone (828) 274-8368

5300 Highway 200
Concord, NC 28025
Phone (704) 788-2304

176 Wildcat Rd
Deep Gap, NC 28618
Phone (828) 262-4540

1107A E Mountain St
Kernersville, NC 27284
Phone (704) 636-8662

9929 Albemarle Rd
Mint Hill, NC 28227
Phone (704) 838-0516

190 Commerce Blvd
Statesville, NC 28625
Phone (704) 838-0516

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1124046198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 FINES CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254441",
            "telephone_number": "704-838-0516",
            "fax_number": "704-838-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 FINES CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254441",
            "telephone_number": "704-880-8665",
            "fax_number": "704-838-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENHANCEMENT MEDICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "PAVELOCK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-838-0516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904288",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.