Family Medical Care of Rowan PA
Organization Active NPI Family Medicine Physician · Spencer, NC
NPI 1528045390 · NPPES record last updated Jun 6, 2008
Key facts
- NPI
- 1528045390
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FAMILY MEDICAL CARE OF ROWAN PA
- Practice address
- 300 N Salisbury Ave
Spencer, NC 28159-2514 - Phone
- (704) 633-7070
- Fax
- (704) 633-7627
- NPI assigned
- Dec 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Lloyd Emery Nickerson, MD
- Title
- Owner Medical Doctor
- Phone
- (704) 633-7070
National Provider Directory
- Tax ID family
- Family Medical Care of Rowan PA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
300 N Salisbury Ave
Spencer, NC 28159-2514
Mailing address
300 N Salisbury Ave
Spencer, NC 28159-2514
Phone (704) 633-7070
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89014CE | Other | NC | MEDICAID |
| 0138R | Other | BCBS GROUP ID | |
| 202595 | Other | BLACK LUNG | |
| 890138R | Medicaid | NC | |
| CL2573 | Other | NC | RAILROAD MEDICARE |
| 970029646 | Other | MEDICARE RAILROAD | |
| 8962644 | Medicaid | NC | |
| 500013139 | Other | MEDICARE RAILROAD | |
| 62644 | Other | BCBS PERSONAL ID |
Other names
- Nickerson Family Medical Care
Other providers in Spencer, NC
- Samuel Dastrup
- Michele Renee Davis
- David Alan Desanto
- Michelle Philbeck Eagle
- Easter Seals Ucp of North Carolina & Virginia, Inc.
- Family Medical Care of Rowan-Spencer
- Robin Starr Forbis
- Future Focus, Inc
- Gloris Harris
- Lakisha S Hayes
All providers in Spencer, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.