IREDELL PRIMARY CARE
NPI 1861147779
Family Medicine in Mooresville, NC
About Iredell Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IREDELL PRIMARY CARE (NPI 1861147779) is a healthcare organization registered as a family medicine in Mooresville, North Carolina and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Carla D Johnson, Director Of Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Iredell Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
116Medicare enrollment records show 116 clinicians reassign Medicare billing to Iredell Primary Care, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 16 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 23
Nearest to this location (20)
See all 116Source: 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 34D2258920
Iredell Primary Care · Mooresville, NCFrequently 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 1861147779. It was assigned to this organization in the NPPES registry on February 18, 2022. The provider is doing business as Iredell Primary Care.
Where is Iredell Physician Network LLC located?
Iredell Physician Network LLC is located at 114 Gateway Blvd Ste B, Mooresville, NC 28117. The listed phone number is (980) 435-0406.
What is Iredell Physician Network LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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, 1 practice at this address and 16 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 34D2258920) is associated with this NPI, valid through April 27, 2028. 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 March 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Iredell Primary Care · NPI 1861147779
Family Medicine organization in Mooresville, North Carolina. Organization record, active in the CMS NPPES registry since February 18, 2022.
## Identity
- **NPI:** 1861147779 (Entity type: Organization)
- **Enumerated:** February 18, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Iredell Physician Network Llc
- **Organization subpart:** Yes (part of Iredell Physician Network Llc)
- **Authorized official:** Carla Johnson, DIRECTOR OF OPERATIONS
## Practice location
- **Address:** 114 GATEWAY BLVD STE B, Mooresville, NC 28117-5598
- **Phone:** (980) 435-0406 · **Fax:** (980) 435-0409
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 116 clinicians in 23 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Registered Nurse Anesthetist (CRNA) (39), Nurse Practitioner (29), Family Practice (10); 1 practice at this address and 16 within 10 miles; [full list](https://npiprofile.com/npi/1861147779/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861147779) · Data from the CMS NPPES public registry.