| Geriatric Consultants Pllc | |
|
220 13th Avenue Pl Nw Hickory NC 28601-2532 | |
| (914) 843-9637 | |
| Not Available |
| Full Name | Geriatric Consultants Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 220 13th Avenue Pl Nw, Hickory, North Carolina |
| Authorized Official Name and Position | Brad Markowitz (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9148439637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Consultants Pllc 10 Loughlin Ave Cos Cob CT 06807-2616 Ph: () - | Geriatric Consultants Pllc 220 13th Avenue Pl Nw Hickory NC 28601-2532 Ph: (914) 843-9637 |
| NPI Number | 1801478086 |
|---|---|
| Provider Enumeration Date | 04/27/2021 |
| Last Update Date | 11/08/2022 |
| Medicare PECOS PAC ID | 5294132387 |
|---|---|
| Medicare Enrollment ID | O20210915003266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801478086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Stephanie Gould Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831172030 PECOS PAC ID: 7113822875 Enrollment ID: I20031204001110 |
| Provider Name | Melissa M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285783415 PECOS PAC ID: 7810896891 Enrollment ID: I20040108000350 |
| Provider Name | Kevin Richard Clark |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053373399 PECOS PAC ID: 5799735445 Enrollment ID: I20050131000236 |
| Provider Name | Lisa M Caporossi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407969694 PECOS PAC ID: 6709832280 Enrollment ID: I20050328000934 |
| Provider Name | John D Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528047248 PECOS PAC ID: 1456249374 Enrollment ID: I20050401000627 |
| Provider Name | John Steven Corder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154300820 PECOS PAC ID: 0941257984 Enrollment ID: I20050401000639 |
| Provider Name | Isabelle H Eustice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821021080 PECOS PAC ID: 1052446093 Enrollment ID: I20100316000995 |
| Provider Name | Edward Thurman Plyler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316988058 PECOS PAC ID: 9335193242 Enrollment ID: I20100722000585 |
| Provider Name | Judith Harris Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336479815 PECOS PAC ID: 0840471207 Enrollment ID: I20110218000410 |
| Provider Name | Sunshine Marie Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992046833 PECOS PAC ID: 0143466193 Enrollment ID: I20130417000193 |
| Provider Name | Kadye Barker Mccaslin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750634408 PECOS PAC ID: 1153557699 Enrollment ID: I20131112000312 |
| Provider Name | Priscilla Deon Kopper Duckworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922410414 PECOS PAC ID: 5294952065 Enrollment ID: I20140819001375 |
| Provider Name | Aminu Isyaku Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205271145 PECOS PAC ID: 6406098599 Enrollment ID: I20140903001211 |
| Provider Name | James Walter Goforth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811945470 PECOS PAC ID: 9638320617 Enrollment ID: I20141103001566 |
| Provider Name | Wendy Brown Moose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386044501 PECOS PAC ID: 9335361146 Enrollment ID: I20141111002552 |
| Provider Name | Denise W Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033584750 PECOS PAC ID: 7012213994 Enrollment ID: I20160303001127 |
| Provider Name | Ronald Andrew Noe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710320122 PECOS PAC ID: 5991020265 Enrollment ID: I20161012000922 |
| Provider Name | Mykah Payne Wike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821538893 PECOS PAC ID: 2769768357 Enrollment ID: I20170413002215 |
| Provider Name | Amanda Ruth Lanier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952836405 PECOS PAC ID: 5496028284 Enrollment ID: I20170830000012 |
| Provider Name | Joel Mitchell Blass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154429850 PECOS PAC ID: 1850292475 Enrollment ID: I20171010000008 |
| Provider Name | Summer Graham Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023590973 PECOS PAC ID: 6800140112 Enrollment ID: I20181126000688 |
| Provider Name | Judy Porter Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619441284 PECOS PAC ID: 5890036412 Enrollment ID: I20190409001969 |
| Provider Name | Neenah Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639735277 PECOS PAC ID: 5991039695 Enrollment ID: I20190701000953 |
| Provider Name | Heather Taylor Lackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023673993 PECOS PAC ID: 7719216456 Enrollment ID: I20190905003359 |
| Provider Name | Chrystal D Gammon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073165148 PECOS PAC ID: 2365876729 Enrollment ID: I20191218002271 |
| Provider Name | Oscar Njihi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780225458 PECOS PAC ID: 3274964614 Enrollment ID: I20200519000662 |
| Provider Name | Dewey Todd Detar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750499604 PECOS PAC ID: 6305872029 Enrollment ID: I20200603002456 |
| Provider Name | Sharon Alene Welborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023614906 PECOS PAC ID: 9638583115 Enrollment ID: I20210123000161 |
| Provider Name | Angela Nicole Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790458875 PECOS PAC ID: 4688072788 Enrollment ID: I20211004002080 |
| Provider Name | Ann L Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679947527 PECOS PAC ID: 0547564585 Enrollment ID: I20220404001760 |
| Provider Name | Michael Edwin Tipton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316677982 PECOS PAC ID: 8022498997 Enrollment ID: I20220708003202 |
| Provider Name | Shenika Lenette Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427706597 PECOS PAC ID: 7618351313 Enrollment ID: I20220830001475 |
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