Individual provider Active NPI

Mary Ellen Torres, MD

  • Obstetrics & Gynecology Physician
  • Statesville, NC
National Provider Identifier
1508977927
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
93-00613 Issued in NC
Practice address
1804 Davie Ave
Statesville, NC 28677-3524
Phone
(704) 873-7250
Fax
(704) 878-9457
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 93-00613 NC Primary

Addresses

Primary practice location

1804 Davie Ave
Statesville, NC 28677-3524

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Other identifiers 1

IdentifierTypeStateIssuer
54273722MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000672 NC Practitioner - Obstetrics/Gynecology 3072555895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

1804 Davie Ave
Statesville, NC 28677-3524
Phone (704) 873-7250

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Jun 1, 2011 Accepting new patients
Piedmont Healthcare, P.a. Obstetrics & Gynecology CurrentSince Jun 1, 2011 Accepting new patients
Laurel OB GYN Associates, P.a. Obstetrics & Gynecology PastSince Jun 1, 1994 Accepting new patients

Locations

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

1804 Davie Ave
Statesville, NC 28677
Phone (704) 873-7250

Interoperability endpoints

  • Direct secure messaging: marytorres@phc.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1508977927",
    "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",
            "fax_number": "704-878-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773524",
            "telephone_number": "704-873-7250",
            "fax_number": "704-878-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "93-00613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54273722",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.