Individual provider Active NPI

Anita Misra, M.D.

  • Internal Medicine Physician
  • Statesville, NC
National Provider Identifier
1750381562
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2005-01575 Issued in NC
Practice address
208 Old Mocksville Rd
Statesville, NC 28625-1953
Phone
(704) 838-8249
Fax
(704) 838-8209
NPI assigned
Jul 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2005-01575 NC Primary

Addresses

Primary practice location

208 Old Mocksville Rd
Statesville, NC 28625-1953

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 838-8249

Other identifiers 1

IdentifierTypeStateIssuer
5902444MedicaidNC

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
I20051207000751 NC Practitioner - Internal Medicine 4789605619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

533 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 838-8249

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2005-01575NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, P.a. Internal Medicine CurrentSince Sep 1, 2009 Accepting new patients
Piedmont Healthcare, PA CurrentSince Sep 1, 2009 Accepting new patients
Access Medical Group,PC Internal Medicine PastSince Feb 1, 2007 Accepting new patients

Locations

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

533 Brookdale Dr
Statesville, NC 28677
Phone (704) 838-8249

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

Interoperability endpoints

  • Direct secure messaging: anitamisra@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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1750381562",
    "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": "704-838-8249",
            "fax_number": "704-838-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251953",
            "telephone_number": "704-838-8249",
            "fax_number": "704-838-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "ANITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2005-01575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902444",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.