STATESVILLE CARDIOVASCULAR CLINIC
NPI 1235410960
Internal Medicine - Cardiovascular Disease in Statesville, NC

Active since September 08, 2011CLIA 34D0897936 · Waiver
738 BRYANT ST STE A, STATESVILLE, NC 28677(704) 873-1189(704) 873-1116 Get Directions Write a Review

NPPES record last updated: April 5, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Statesville Cardiovascular Clinic NPPES

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

STATESVILLE CARDIOVASCULAR CLINIC (NPI 1235410960) is a healthcare organization registered as a cardiovascular disease in Statesville, North Carolina and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through October 11, 2027 and lists Kathryn Heles, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1235410960
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameIREDELL PHYSICIAN NETWORK LLC
Location Address738 BRYANT ST STE AStatesville, NC 28677-4189
Mailing AddressPo Box 896199Charlotte, NC 28289-6199 · (833) 936-1364 · Fax (605) 942-7505
Fax(704) 873-1116
Organization SubpartYes
Authorized OfficialKathryn HelesCredentialing · (866) 340-0396
Enumeration DateSeptember 8, 2011
Last NPPES UpdateApril 5, 2021
NPPES CertifiedApril 5, 2021
✔ NPI 1235410960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
738 BRYANT ST STE A, Statesville, NC 28677

Other Names 1

Doing Business AsStatesville Cardiovascular Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Statesville Cardiovascular Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

116

Medicare enrollment records show 116 clinicians reassign Medicare billing to Statesville Cardiovascular Clinic, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 51 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 23

Certified Registered Nurse Anesthetist (CRNA)39
Nurse Practitioner29
Family Practice10
Internal Medicine8
Emergency Medicine5
Cardiovascular Disease (Cardiology)3
Psychiatry3
Interventional Pain Management2
15 other specialties17

Nearest to this location (20)

See all 116
Cardiovascular Disease (Cardiology)
NPI 1932214137
738 BRYANT ST SUITE A
Statesville, NC 28677
(704) 873-1180
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1659311207
738 BRYANT ST SUITE A
Statesville, NC 28677
(704) 873-1189
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1952620536
738 BRYANT ST STE A
Statesville, NC 28677
(704) 873-1189
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1497723795
738 BRYANT ST
Statesville, NC 28677
(704) 230-4382
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1558703090
738 BRYANT ST STE A
Statesville, NC 28677
(704) 873-1116
✔ PECOS✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1083540645
740 BRYANT ST
Statesville, NC 28677
(704) 878-6272
Same address
Internal Medicine
NPI 1326157991
757 BRYANT ST
Statesville, NC 28677
(704) 873-5658
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1457996274
766 HARTNESS RD
Statesville, NC 28677
(704) 954-8277
✔ PECOS✔ Accepts Medicare0.1 mi
Neurosurgery
NPI 1508868647
766 HARTNESS RD STE C
Statesville, NC 28677
(704) 954-8277
✔ PECOS✔ Accepts Medicare0.1 mi
Interventional Pain Management
NPI 1669091260
766 HARTNESS RD STE A
Statesville, NC 28677
(704) 360-4378
✔ PECOS✔ Accepts Medicare0.1 mi
Pediatric Medicine
NPI 1699188912
728 HARTNESS RD
Statesville, NC 28677
(704) 360-6420
✔ PECOS0.1 mi
Vascular Surgery
NPI 1215912258
770 HARTNESS RD
Statesville, NC 28677
(704) 873-5594
✔ PECOS✔ Accepts Medicare0.1 mi
Orthopedic Surgery
NPI 1396777066
774 HARTNESS RD
Statesville, NC 28677
(704) 768-3030
✔ PECOS✔ Accepts Medicare0.1 mi
Psychiatry
NPI 1003254806
515 BROOKDALE DR
Statesville, NC 28677
(704) 380-3620
✔ PECOS0.2 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1306869870
557 BROOKDALE DR
Statesville, NC 28677
(704) 873-5661
✔ Accepts Medicare0.2 mi
Certified Registered Nurse Anesthetist (CRNA)
NPI 1093739575
557 BROOKDALE DR
Statesville, NC 28677
(704) 873-5661
✔ Accepts Medicare0.2 mi
Internal Medicine
NPI 1609259183
557 BROOKDALE DR
Statesville, NC 28677
(704) 997-5525
✔ PECOS✔ Accepts Medicare0.2 mi
Nurse Practitioner
NPI 1316315039
557 BROOKDALE DR
Statesville, NC 28677
(704) 873-5661
✔ PECOS0.2 mi
Diagnostic Radiology
NPI 1982606281
557 BROOKDALE DR
Statesville, NC 28677
(704) 878-4510
✔ PECOS✔ Accepts Medicare0.2 mi
Family Practice
NPI 1518081520
310 DAVIE AVE
Statesville, NC 28677
(704) 873-3269
✔ PECOS✔ Accepts Medicare0.7 mi
See all 116 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 34D0897936

Statesville Cardiovascular Clinic PA · Statesville, NC
Active · expires Oct 11, 2027
CLIA Number34D0897936
Laboratory TypePhysician Office
Certificate Effective DateOctober 12, 2025
Certificate Expiration DateOctober 11, 2027
Laboratory DirectorNaim Bouhussein
Laboratory Phone(704) 873-1189
Laboratory LocationStatesville Cardiovascular Clinic PA738 A Bryant St, Suite A, Statesville, NC 28677
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1235410960. It was assigned to this organization in the NPPES registry on September 8, 2011. The provider is doing business as Statesville Cardiovascular Clinic.

Where is Iredell Physician Network LLC located?

Iredell Physician Network LLC is located at 738 Bryant St Ste A, Statesville, NC 28677. The listed phone number is (704) 873-1189.

What is Iredell Physician Network LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Iredell Physician Network LLC enrolled in Medicare?

Yes. Iredell Physician Network LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Iredell Physician Network LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 116 clinicians in 23 Medicare specialties reassign their Medicare billing to Iredell Physician Network LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (39), Nurse Practitioner (29) and Family Practice (10). Of these, 6 practice at this address and 51 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Iredell Physician Network LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0897936) is associated with this NPI, valid through October 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Iredell Physician Network LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next list Iredell Physician Network LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Iredell Physician Network LLC was last updated on April 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.