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Export Provider Record NPI 1003567082
Mooresville Ppm, Llc
Organization Subpart: YES
Active
NPI Number1003567082
NPI TypeNPI-2 Organization
SpecialtyInternal Medicine, Interventional Cardiology
Provider Details
NPI1003567082
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2022-01-12
Last Updated2022-01-12
Authorized OfficialJennifer Jackson
Sr Dir Prov Enroll & Onboarding
Phone: 6154653334
Mailing AddressPo Box 689022
Franklin, TN 37068-9022
United States
Phone: (615) 465-7230 | Fax: (615) 628-6677
📍 View Map
Primary Practice Address1424 Fern Creek Dr Ste D
Statesville, NC 28625-9376
United States
Phone: (704) 878-2058 | Fax: (704) 872-6576
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207RI0011X – Internal Medicine, Interventional Cardiology
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About NPI 1003567082

Mooresville Ppm, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1003567082. The primary specialty listed is Internal Medicine, Interventional Cardiology. The organization is located in Statesville, NC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2022-01-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1003567082?

NPI 1003567082 belongs to Mooresville Ppm, Llc, a Internal Medicine, Interventional Cardiology in Statesville, NC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1003567082 active?

The current status of NPI 1003567082 in the NPPES registry is Active. The record was last updated on 2022-01-12.

What specialty is NPI 1003567082?

NPI 1003567082 is classified under the taxonomy Internal Medicine, Interventional Cardiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1003567082?

You can verify NPI 1003567082 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1003567082?

The primary practice address on file for NPI 1003567082 is 1424 Fern Creek Dr Ste D, Statesville, NC 28625-9376. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1003567082 issued?

NPI 1003567082 was first issued (enumerated) on 2022-01-12. The NPPES record was last updated on 2022-01-12.

Practice Location Map

Mooresville Ppm, Llc is located at 1424 Fern Creek Dr Ste D, Statesville, NC. Use the map below to find directions or verify the practice location.

📍 1424 Fern Creek Dr Ste D, Statesville, NC 28625-9376  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Mooresville Ppm, Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-06 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162