Individual provider Active NPI

Ella Davila-Hernandez

  • Family Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1952707473
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007318 Issued in NC
Practice address
128 E Plaza Dr Ste 3
Mooresville, NC 28115-8000
Phone
(980) 444-2630
Fax
(980) 444-2631
NPI assigned
Nov 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5007318 NC Primary

Addresses

Primary practice location

128 E Plaza Dr Ste 3
Mooresville, NC 28115-8000

Mailing address

PO Box 896199
Charlotte, NC 28289-4358
Phone (833) 963-1364

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150115001549 NC Practitioner - Nurse Practitioner 7911221262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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)

Statesville, NC 28677
Phone (704) 838-2182

738 Bryant St
Statesville, NC 28677-4189
Phone (704) 873-2219

766 Hartness Rd
Suite B
Statesville, NC 28677-3479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Nov 1, 2016 Accepting new patients
Iredell Physician Network LLC Current Accepting new patients
Iredell Physician Network, LLC CurrentSince Nov 1, 2016 Accepting new patients
Iredell Physician Network LLC Family Medicine Past Accepting new patients

Locations

128 E Plaza Dr
Ste 3
Mooresville, NC 28115
Phone (704) 378-8478

653 Bluefield Rd
Ste B
Mooresville, NC 28117
Phone (980) 444-2630

728 Hartness Rd
Statesville, NC 28677
Phone (704) 380-6420

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

774 Hartness Rd
Statesville, NC 28677
Phone (704) 768-3030

Interoperability endpoints

  • Direct secure messaging: elladavila-hernandez@imhi.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1952707473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896199",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282894358",
            "telephone_number": "833-963-1364",
            "fax_number": "605-942-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E PLAZA DR STE 3",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281158000",
            "telephone_number": "980-444-2630",
            "fax_number": "980-444-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA-HERNANDEZ",
        "first_name": "ELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.