Nc Immunology, PC
NPI 1619785920ActiveOrganization· Allergy & Immunology· Statesville, NC
Allergy & Immunology in Statesville, North Carolina, registered in NPPES in December 2024. The authorized official on file is Anna M. Jackson, Office Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619785920 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 19, 2024 |
| Last updated in NPPES | Sep 23, 2026 |
| Certified by provider | Sep 23, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Allergy & Immunology Primary | 207K00000X | — | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — | — |
| Internal Medicine, Rheumatology | 207RR0500X | — | — |
| Clinic/Center, Infusion Therapy | 261QI0500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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