Carla R Pence, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30451 Issued in NC

Practice address

1818 Davie Ave
Statesville, NC 28677-3524

Phone

(704) 873-1036

NPI assigned

Nov 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1811988231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SIGNAL HILL DRIVE EXT",
            "address_2": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-873-4277",
            "fax_number": "704-873-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773524",
            "telephone_number": "704-873-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCE",
        "first_name": "CARLA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "30451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8966728",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey E Payne, DC
• Sara Paz
• Lisa Marie Peggs, PT
• Diane Setzer Pemberton, RN
• Leslie Katelynn Pennell
• Elizabeth Robie Perdue, MA LPA
• Jose Eduardo Perez Sr., MD
• Patricia Perkins, LPN
• Perry S Justice Jr DDS PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.