Salisbury Pediatric Associates, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SALISBURY PEDIATRIC ASSOCIATES, PA

Practice address

17810 Statesville Rd
Suite 311
Cornelius, NC 28031-8148

Phone

(704) 655-6300

Fax

(704) 655-7997

NPI assigned

Dec 3, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Shepard Sewell Averitt IV, MED.

Title

Administrator

Phone

(704) 216-2020

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Touchstone Health Associates Doing business as

Tax ID family

Salisbury Pediatric Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Salisbury Pediatric Associates PA

  • Pediatric Adolescent Medicine Physician
  • Salisbury, NC
  • NPI 1598862732
  NPD tax ID

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1124356019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WOODSON ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443255",
            "telephone_number": "704-636-5576",
            "fax_number": "704-216-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17810 STATESVILLE RD",
            "address_2": "SUITE 311",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318148",
            "telephone_number": "704-655-6300",
            "fax_number": "704-655-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALISBURY PEDIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "AVERITT",
        "authorized_official_first_name": "SHEPARD",
        "authorized_official_middle_name": "SEWELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-216-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MED."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902597",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Touchstone Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael G Ryan, M.D.
• Heather Lucia Rypien, AGPCNP-C
• Safe Home Pro, Inc.
• Safety Harbor Assessment and Therapy Services, PLLC
• Joseph Anthony Saglimbeni II, LCMHC-A, NCC
• Nancy A Samson, PHYSICAL THERAPIST
• Christina Lynn Sanders, PHARMD
• Cassandra Lynn Santus, CRNA
• Karsen Sawyer
• Saylor Physical Therapy Cornelius LLC

• Pediatrics Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.