South Park Medical Clinic PA
NPI 1083614564 · Family Medicine Physician · Hickory, NC
South Park Medical Clinic PA is a Family Medicine Physician organization in Hickory, NC (NPI 1083614564).
Provider details
- NPI number
- 1083614564
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Elbert Rudisill, President(828) 322-5915
- License
- 21863 (NC)
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
20 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
Registry dates
- Enumerated
- 2005-07-27
- Last updated
- 2020-08-22
Frequently asked questions
- What is South Park Medical Clinic PA's NPI number?
- South Park Medical Clinic PA's National Provider Identifier (NPI) is 1083614564, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Park Medical Clinic PA?
- South Park Medical Clinic PA is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is South Park Medical Clinic PA located?
- South Park Medical Clinic PA's practice location on file with NPPES is 133 1st Ave Se, Hickory, NC 28602-3005.
- What is South Park Medical Clinic PA's phone number?
- The practice phone number listed in the NPPES registry for South Park Medical Clinic PA is (828) 322-5915.
- Who is the authorized official for South Park Medical Clinic PA?
- The authorized official listed on South Park Medical Clinic PA's NPPES record is Elbert Rudisill, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Park Medical Clinic PA's NPI active?
- Yes — South Park Medical Clinic PA's NPI (1083614564) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.