CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE – NPI #1730551714
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE is a provider located in STATESVILLE, NC. NPPES has assigned the NPI number 1730551714 to CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE on October 29, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE” is a dba name, the actual legal business name for this organization is STATESVILLE HMA MEDICAL GROUP LLC. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 4 years ago on Jan 14, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE below.

NPI Profile for
STATESVILLE HMA MEDICAL GROUP LLC

NPI Number
1730551714
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
STATESVILLE HMA MEDICAL GROUP LLC
Doing Business As (dba): CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE
Primary location
1410 FERN CREEK DR
STATESVILLE, NC 28625-9376
Phone: (704) 978-2379 Fax: (704) 978-2380
Mailing address
4000 MERIDIAN BLVD
FRANKLIN, TN 37067-6325
Phone: (615) 465-7230 Fax:
Organization Subpart
Yes - CAROLINA PEDIATRIC AND ADOLESCENT MEDICINE is subpart of another organization.
Authorized Official
JENNIFER JACKSON
SR DIR PROV ENROLLMENT & ONBOARDING
Phone: (615) 465-3334
Updated
Certification Date
Jan 14, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.