| Caldwell Memorial Hospital, Inc. | |
|
30 13th Ave Nw Hickory NC 28601-3765 | |
| (828) 324-0100 | |
| Not Available |
| Full Name | Caldwell Memorial Hospital, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 30 13th Ave Nw, Hickory, North Carolina |
| Authorized Official Name and Position | Karen Shadowens (CFO) |
| Authorized Official Contact | 3366278512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caldwell Memorial Hospital, Inc. 321 Mulberry St Sw Lenoir NC 28645-5720 Ph: (828) 757-5100 | Caldwell Memorial Hospital, Inc. 30 13th Ave Nw Hickory NC 28601-3765 Ph: (828) 324-0100 |
| NPI Number | 1417661976 |
|---|---|
| Provider Enumeration Date | 01/10/2023 |
| Last Update Date | 01/10/2023 |
| Medicare PECOS PAC ID | 5395646970 |
|---|---|
| Medicare Enrollment ID | O20230705003417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417661976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jenette T Swisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295757318 PECOS PAC ID: 1658368907 Enrollment ID: I20040428000851 |
| Provider Name | Timothy W Bradshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417271867 PECOS PAC ID: 5698803922 Enrollment ID: I20100507000058 |
| Provider Name | May Khang Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437493954 PECOS PAC ID: 6103055678 Enrollment ID: I20140804000199 |
| Provider Name | Megan Pellerin Kimball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437418613 PECOS PAC ID: 6002036498 Enrollment ID: I20160819001683 |
| Provider Name | Michael Joseph Rewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205298338 PECOS PAC ID: 2062780240 Enrollment ID: I20191008003489 |
| Provider Name | David Jacob Fair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942993324 PECOS PAC ID: 2264880640 Enrollment ID: I20231122003104 |
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