Andrea Evbu Iyekepolo

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2022-00851 Issued in NC

Practice address

129 Sherlock Dr
Statesville, NC 28625-1916

Phone

(704) 838-8245

Fax

(704) 924-4282

NPI assigned

Jun 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, TX, NC3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Pediatric Medicine

Education

Southern Illinois University School of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aiyekepolo1641015@direct.novanthealth.org
• Direct secure messaging: andrea.iyekepolo.1@20247.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DLP Maria Parham Physician Practices, LLC

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1215273628
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• The Presbyterian Hospital

  • Geriatric Medicine (Internal Medicine) Physician
  • Charlotte, NC
  • NPI 1053365817
  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network, Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1578939914
  NPD
• DLP Maria Parham Physician Practices LLC

  • Rural Health Clinic/Center
  • Henderson, NC
  • NPI 1578256749
  NPD
• DLP Maria Parham Physician Practices, LLC

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1720364649
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Hospitalist Physician
  • Winston Salem, NC
  • NPI 1740903566
  NPD

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

{
    "created_epoch": "1466294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1285084426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 SHERLOCK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251916",
            "telephone_number": "704-838-8245",
            "fax_number": "704-924-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYEKEPOLO",
        "first_name": "ANDREA",
        "middle_name": "EVBU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "EL191038",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-00851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iredell Surgical Associates, LLP
• Iredell-Statesville Schools
• Iredell-Statesville Schools
• Daniela Getuza Isfan, M.D.
• Jarrett Isler
• J&B Courier Servies LLC
• Jack D. King, DDS, PA
• James a Vacca DDS Msco PA
• James a. Smith MD Pediatrics
• James M. Rhyne, MD,PA

• Pediatrics Physician in Statesville, NC
• Providers in Statesville, 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 Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.