Active NPI
Alisa C Nance, MD
- Family Medicine Physician
- Mooresville, NC
National Provider Identifier
1265423685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9900622
- Practice address
- 150 Fairview Rd
Suite 210
Mooresville, NC 28117-9500 - Phone
- (704) 235-0300
- NPI assigned
- Nov 3, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9900622 | NC | Primary |
Addresses
Primary practice location
150 Fairview Rd
Suite 210
Mooresville, NC 28117-9500
Mailing address
650 Signal Hill Drive Ext
PO Box 1845
Statesville, NC 28625-4353
Phone (704) 873-4277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891197U | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- alisanance@phc.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390435200000",
"number": "1265423685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 SIGNAL HILL DRIVE EXT",
"address_2": "PO BOX 1845",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254353",
"telephone_number": "704-873-4277",
"fax_number": "704-873-4511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 FAIRVIEW RD",
"address_2": "SUITE 210",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281179500",
"telephone_number": "704-235-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANCE",
"first_name": "ALISA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-03",
"last_updated": "2014-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "9900622",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891197U",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.