Charles A Deberardinis, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2010-00361 Issued in NC

Practice address

738 Bryant St
Suite a
Statesville, NC 28677-4189

Phone

(704) 873-1189

NPI assigned

Jun 8, 2006

Last updated

Mar 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Rowan University School of Osteopathic Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.deberardinis@iredell.cernerdirect.com
• Direct secure messaging: charlesdeberardinis@imhi.allscriptsdirect.net

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

• Iredell Physician Network LLC

  • General Practice Physician
  • Statesville, NC
  • NPI 1811381593
  Medicare reassignment Care Compare group NPD
• Legacy Heart Care of Charlotte, LLC

  dba Flow Therapy Charlotte

  • Cardiovascular Disease Physician
  • Charlotte, NC
  • NPI 1467810663
  Medicare reassignment NPD
• Iredell Physician Network

  dba Iredell Neurospine

  • Neurological Surgery Physician
  • Hickory, NC
  • NPI 1023402732
  NPD
• Iredell Physician Network LLC

  dba Iredell Ear, Nose and Throat

  • Otolaryngology Physician
  • Statesville, NC
  • NPI 1447063920
  NPD
• James M. Rhyne, MD,PA

  • Primary Care Clinic/Center
  • Statesville, NC
  • NPI 1740282698

  Cardiovascular Disease

  NPD
• Iredell Physician Network LLC

  dba Bremnor Family Medicine

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1780822288
  NPD (past)

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

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1659311207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 BRYANT ST",
            "address_2": "SUITE A",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774189",
            "telephone_number": "704-873-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 BRYANT ST",
            "address_2": "SUITE A",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774189",
            "telephone_number": "704-873-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERARDINIS",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "N1610",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2010-00361",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "201000361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913902",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Kimberly Daywalt, FNP
• Ricardo De Leon, M.D.
• Krystal Parker Deal, RN
• Paulette Deal, RPH
• Sarah Deal, SLP
• Lorenzo Keith Debose
• Alan E Deddens, M.D.
• Dedicated Psychological Solutions, PLLC
• Sarah Hardin Dellinger, LCAS
• Charalambos Demetri, DO

• Cardiovascular Disease Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.