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1093790859

NPI Code Detail

MEDICARE: COUNTY OF IREDELL

MEDICARE: COUNTY OF IREDELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	34D0247311	NC
2	261QC1500X	Community Health Clinic/Center
3	261QD0000X	Dental Clinic/Center
4	251B00000X	Case Management Agency
5	261QM2500X	Medical Specialty Clinic/Center
6	261QF0050X	Non-Surgical Family Planning Clinic/Center
7	261QP2300X	Primary Care Clinic/Center
8	261QP0905X	State or Local Public Health Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	28496	OTHER	NC	PARTNERS MEDICARE
3	600001111	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0728F	OTHER	NC	BCBS PROVIDER #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093790859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF IREDELL

Provider Business Mailing Address
First Line	:	318 TURNERSBURG HWY
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28625-2798
Country	:	US
Telephone Number	:	704-878-5300
Fax Number	:	704-878-5357

Provider Business Practice Location Address
First Line	:	318 TURNERSBURG HWY
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28625-2798
Country	:	US
Telephone Number	:	704-878-5300
Fax Number	:	704-878-5357

Authorized Official
Title or Position	:	HEALTH DIRECTOR
Name	:	BRADY FREEMAN
Credential	:
Telephone Number	:	704-878-5300

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	04/27/2026

Similar Medicare Providers

1912191560 — MRS. MONICA NORA SLUBICKI M.D.
Practice Location Address:

318 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 919-985-2526
Practice Fax: 919-852-5267

1427076579 — MRS. LINDSAY LITTELL WEAVER LPC
Practice Location Address:

318 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 704-402-1060
Practice Fax: 704-402-1065

1477654192 — MS. SUSAN MAYBERRY JOHNSON RN
Practice Location Address:

318 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 704-878-5300
Practice Fax:

1336233519 — MRS. SARAH G. BORDERS LPC
Practice Location Address:

351 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 704-871-1712
Practice Fax: 704-871-9354

1134216278 — MRS. DIANE SETZER PEMBERTON RN
Practice Location Address:

318 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 704-878-5300
Practice Fax: 704-878-5311

1942398896 — LORI GREER GRAY RN
Practice Location Address:

318 TURNERSBURG HWY
STATESVILLE, NC
28625-2798

Practice Phone: 704-878-5300
Practice Fax:

Directions to “COUNTY OF IREDELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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