MEDICARE: COMMUNITY CARE HEALTH PARTNERS PLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396691762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CARE HEALTH PARTNERS PLLC

Provider Business Mailing Address
First Line	:	723 S VAN BUREN RD STE B
Second Line	:
City	:	EDEN
State	:	NC
Zip	:	27288-5418
Country	:	US
Telephone Number	:	336-623-5171
Fax Number	:	336-627-5747

Provider Business Practice Location Address
First Line	:	723 S VAN BUREN RD STE B
Second Line	:
City	:	EDEN
State	:	NC
Zip	:	27288-5418
Country	:	US
Telephone Number	:	336-623-5171
Fax Number	:	336-627-5747

Authorized Official
Title or Position	:	DIRECTOR OF MSO REVENUE INTEGRITY
Name	:	MELISSA STONE
Credential	:	STONE
Telephone Number	:	603-233-9246

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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