Mooresville Ppm, LLC
NPI 1003567082 · Interventional Cardiology Physician · Statesville, NC
Mooresville Ppm, LLC is a Interventional Cardiology Physician organization in Statesville, NC (NPI 1003567082).
Provider details
- NPI number
- 1003567082
- Entity type
- Organization
- Primary specialty
- Interventional Cardiology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Mooresville Ppm, LLC
- Organization subpart
- Yes
- Authorized official
- Jennifer Jackson, Sr Dir Prov Enroll & Onboarding(615) 465-3334
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Lake Norman Medical Group Heart & Vascular Statesville
Registry dates
- Enumerated
- 2022-01-12
- Last updated
- 2022-01-12
- Certified
- 2022-01-12
Frequently asked questions
- What is Mooresville Ppm, LLC's NPI number?
- Mooresville Ppm, LLC's National Provider Identifier (NPI) is 1003567082, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mooresville Ppm, LLC?
- Mooresville Ppm, LLC is classified in the NPPES registry as Interventional Cardiology Physician (Allopathic & Osteopathic Physicians).
- Where is Mooresville Ppm, LLC located?
- Mooresville Ppm, LLC's practice location on file with NPPES is 1424 Fern Creek Dr Ste D, Statesville, NC 28625-9376.
- What is Mooresville Ppm, LLC's phone number?
- The practice phone number listed in the NPPES registry for Mooresville Ppm, LLC is (704) 878-2058.
- Who is the authorized official for Mooresville Ppm, LLC?
- The authorized official listed on Mooresville Ppm, LLC's NPPES record is Jennifer Jackson, Sr Dir Prov Enroll & Onboarding. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mooresville Ppm, LLC's NPI active?
- Yes — Mooresville Ppm, LLC's NPI (1003567082) is active in the NPPES registry as of the last update on 2022-01-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.