IREDELL URGENT CARE STATESVILLE
NPI 1053018648
Clinic/Center - Urgent Care in Statesville, NC

Active since February 14, 2023CLIA 34D2278757 · Waiver
1540 E BROAD ST, STATESVILLE, NC 28625(704) 878-4542 Get Directions Write a Review

NPPES record last updated: February 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 21, 2023, Feb 14, 2023 (2 updates tracked since 2023).

About Iredell Urgent Care Statesville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IREDELL URGENT CARE STATESVILLE (NPI 1053018648) is a healthcare organization registered as an urgent care in Statesville, North Carolina and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through March 22, 2027 and lists Joanie M Cochran, Credentialing Agent, as its authorized official.

NPPES Registry Identity

NPI1053018648
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameIREDELL PHYSICIAN NETWORK, LLC
Location Address1540 E BROAD STStatesville, NC 28625-4302
Mailing Address1540 E Broad StStatesville, NC 28625-4302
Organization SubpartNo
Authorized OfficialJoanie M CochranCredentialing Agent · (336) 306-9755
Enumeration DateFebruary 14, 2023
Last NPPES UpdateFebruary 21, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 21, 2023
NPI 1053018648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
1540 E BROAD ST, Statesville, NC 28625

Other Names 1

Doing Business AsIredell Urgent Care Statesville

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2278757

Iredell Urgent Care - Statesville · Statesville, NC
Active · expires Mar 22, 2027
CLIA Number34D2278757
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorJohn Nicholson
Laboratory Phone(704) 380-6900
Laboratory LocationIredell Urgent Care - Statesville1540 East Broad Street, Statesville, NC 28625
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1540 E BROAD ST
STATESVILLE, NC 28625

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Iredell Physician Network, LLC's NPI number?

The NPI number for Iredell Physician Network, LLC is 1053018648. It was assigned to this organization in the NPPES registry on February 14, 2023. The provider is doing business as Iredell Urgent Care Statesville.

Where is Iredell Physician Network, LLC located?

Iredell Physician Network, LLC is located at 1540 E Broad St, Statesville, NC 28625. The listed phone number is (704) 878-4542.

What is Iredell Physician Network, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Does Iredell Physician Network, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2278757) is associated with this NPI, valid through March 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Iredell Physician Network, LLC was last updated on February 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.