Statesville Hma Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STATESVILLE HMA MEDICAL GROUP, LLC

Doing business as

Davis Family Medicine Center

Practice address

1414 Fern Creek Dr
Statesville, NC 28625

Phone

(704) 978-2250

Fax

(704) 978-2257

NPI assigned

Jan 17, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer L Jackson

Title

Sr Dir Prov Enrollment & Onboarding

Phone

(615) 465-3334

Specialties & licenses 1

Addresses

Other names 1

• Davis Family Medicine Center Doing business as

Locations

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1811292295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28625",
            "telephone_number": "704-978-2250",
            "fax_number": "704-978-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESVILLE HMA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-17",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davis Family Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Davis Family Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Medical Group, LLC
• Statesville Hma Physician Management Inc
• Statesville Hma Physician Management, Inc
• Statesville Hma, LLC
• Statesville Medical Management Services, LLC

• Family Medicine Physician in Statesville, NC
• Providers in Statesville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.