NPIMap

Organization Active NPI

Statesville Hma, LLC

Doing business as Davis Regional Med Center CRNA

  • Certified Registered Nurse Anesthetist
  • Statesville, NC
National Provider Identifier
1285849760
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
STATESVILLE HMA, LLC
Doing business as
Davis Regional Med Center CRNA
Practice address
218 Old Mocksville Rd
Statesville, NC 28625-1930
Phone
(704) 838-7102
NPI assigned
May 10, 2007
Last updated
Jun 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Authorized official

Name
Timothy Parry, ESQ
Title
Sr VP and General Counsel
Phone
(239) 598-3176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

218 Old Mocksville Rd
Statesville, NC 28625-1930

Mailing address

218 Old Mocksville Rd
Statesville, NC 28625-1930
Phone (704) 838-7102

Other identifiers 1

IdentifierTypeStateIssuer
8000282MedicaidMS

Other names 1

  • Davis Regional Med Center CRNA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1285849760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-838-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-838-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESVILLE HMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "PARRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SR VP AND GENERAL COUNSEL",
        "authorized_official_telephone_number": "239-598-3176",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8000282",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davis Regional Med Center CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 14, 2010; 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.