Organization · Type 2 NPI

Mooresville PPM LLC

Family Medicine Physician · Mooresville, NC

NPI number 1215214127 Active

Practice location

417 E Statesville Ave
Mooresville, NC 28115-2590

Call (704) 663-2389 Map

Fax (704) 663-4873

Mailing address

PO Box 689022
Franklin, TN 37068-9022

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

8 other providers at this address

Other family medicine physician providers in Mooresville

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NPI record

NPI: 1215214127
Entity type: Organization (Type 2)
Issued: Nov 5, 2011
Last updated: Jan 14, 2022
Status: Active
Subpart: Yes of Mooresville PPM LLC

Other names

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Mooresville Family Practice · doing business as
Mooresville Family Practice · doing business as

Authorized official

Jennifer L Jackson
SR Dir Prov Enroll & Onboarding
(615) 465-3334

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1215214127

Mooresville PPM LLC's National Provider Identifier is 1215214127, issued on Nov 5, 2011. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Mooresville, NC. The record was last updated on Jan 14, 2022.