IREDELL PRIMARY CARE
NPI 1861147779
Family Medicine in Mooresville, NC

Q: 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.

Q: What is Iredell Physician Network LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since February 18, 2022CLIA 34D2258920 · Waiver

114 GATEWAY BLVD STE B, MOORESVILLE, NC 28117(980) 435-0406(980) 435-0409 Get Directions Write a Review

NPPES record last updated: March 10, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 10, 2022, Feb 18, 2022 (2 updates tracked since 2022).

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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

NPI1861147779

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameIREDELL PHYSICIAN NETWORK LLC

Location Address114 GATEWAY BLVD STE BMooresville, NC 28117-5598

Mailing AddressPo Box 896199Charlotte, NC 28289-6199 · (833) 936-1364 · Fax (312) 277-5144

Phone(980) 435-0406

Fax(980) 435-0409

Organization SubpartYes

Authorized OfficialCarla D JohnsonDirector Of Operations · (704) 873-5661

Enumeration DateFebruary 18, 2022

Last NPPES UpdateMarch 10, 20222 updates tracked since enumeration

NPPES CertifiedMarch 10, 2022

✔ NPI 1861147779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

114 GATEWAY BLVD STE B, Mooresville, NC 28117

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Other Names 1

Doing Business AsIredell Primary Care

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

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, NC

Active · expires Apr 27, 2028

CLIA Number34D2258920

Laboratory TypePhysician Office

Certificate Effective DateApril 28, 2026

Certificate Expiration DateApril 27, 2028

Laboratory DirectorAnthony D. Elkins

Laboratory Phone(980) 435-0406

Laboratory LocationIredell Primary Care114 Gateway Blvd, Suite B, Mooresville, NC 28117

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DR. EVA A IMPERIAL MD

Family Medicine

114 GATEWAY BLVD STE B
MOORESVILLE, NC 28117

Iredell County (980) 435-0409

ANTHONY ELKINS D.O.

Family Medicine

114 GATEWAY BLVD STE B
MOORESVILLE, NC 28117

Iredell County (980) 435-0406

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 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.

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.