Statesville Medical Management Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

STATESVILLE MEDICAL MANAGEMENT SERVICES, LLC

Practice address

1503 E Broad St
Statesville, NC 28625-4301

Phone

(704) 896-3313

NPI assigned

Oct 14, 2014

Organization subpart

No

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

Authorized official

Name

Erika Smith

Title

Manager

Phone

(704) 896-3313

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1740684117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511-A NORTHCROSS DRIVE",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 E BROAD ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254301",
            "telephone_number": "704-896-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESVILLE MEDICAL MANAGEMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-896-3313"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE",
            "identifier": "34D2076118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Physician Management Inc
• Statesville Hma Physician Management, Inc
• Statesville Hma, LLC
• Statesville Primary Care PLLC
• Statesville Vision Center OD, PA
• Thomas Bruce Steadman Sr., MSW, LCSW
• Timothy Robert Stebbins Jr., PHARMD
• Donna Kelley Steele, ED.D., CCC-SLP

• Clinical Medical Laboratory in Statesville, NC
• Providers in Statesville, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.