IREDELL MEMORIAL HOSPITAL INCORPORATED
NPI 1760462196
Skilled Nursing Facility in Statesville, NC
NPI Status: Active since January 20, 2006
Contact Information
557 BROOKDALE DR
STATESVILLE, NC
ZIP 28677
Phone: (704) 873-5661
Fax: (704) 878-4611
- Organization
- Skilled Nursing Facility
- Accepts Insurance
- CLIA Number: 34D0247318
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 02-27-2027
About IREDELL MEMORIAL HOSPITAL INCORPORATED
This page provides the complete NPI Profile along with additional information for Iredell Memorial Hospital Incorporated, a provider established in Statesville, North Carolina operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1760462196 assigned on January 2006. The practitioner's primary taxonomy code is 314000000X with license number H0164 (NC). The provider is registered as an organization and their NPI record was last updated June 2025. The provider's
- NPI
- 1760462196
- Provider Legal Name
- IREDELL MEMORIAL HOSPITAL INCORPORATED
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 557 BROOKDALE DR STATESVILLE, NC 28677
- Location Phone
- (704) 873-5661
- Location Fax
- (704) 878-4611
- Mailing Address
- 557 BROOKDALE DR STATESVILLE, NC 28677
- Mailing Phone
- (704) 873-5661
- Mailing Fax
- (704) 878-4611
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-20-2006
- Last Update Date
- 06-24-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- H0164
- License State
- NC
- Taxonomy Description
- (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
- WellCare Secure Health Bronze - PPO
- WellCare Secure Health Gold - PPO
- WellCare Secure Health Silver - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3405306 | MEDICAID (05) | NC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D0247318
- Facility Type
- Hospital
- Certificate Effective Date
- February 28, 2025
- Certificate Expiration Date
- February 27, 2027
- Laboratory Director
- DR. ASHA C. SIGEI
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Iredell Memorial Hospital Incorporated on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for IREDELL MEMORIAL HOSPITAL INCORPORATED
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 4 | 6 | 2 | 1 | 9 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 8 | 6 | 4 | 1 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 8 + 6 + 4 + 1 + 1 + 8 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1760462196 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1982606281 | ROCCO JOSEPH TRITICO M.D. Individual | Specialist | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 878-4510 |
| 1417944224 | IREDELL MEMORIAL HOSPITAL, INCORPORATED Organization | General Acute Care Hospital | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1114905601 | DR. THOMAS GASTON M.D. Individual | Specialist | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 838-5166 |
| 1548230204 | IREDELL MEMORIAL HOSPITAL, INCORPORATED Organization | General Acute Care Hospital | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1043248610 | IMH PROF INFECT DISEASE Organization | Specialist | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1013941145 | IREDELL PHYSICIAN NETWORK LLC Organization | Specialist | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1144242199 | DAWN COZART CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1306869870 | ANNA BROWER CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1194748665 | LORRAINE ANGEL CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1134142466 | KAREN COURTS CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1033132485 | KAREN KAUFFMAN CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5561 |
| 1487677837 | DOTTIE LINYARD CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5561 |
| 1750305256 | DAVID HENSLEY CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1053335240 | SYLVIA SELF CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1033133228 | BARBARA LEE THOMAS CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5561 |
| 1306860614 | ANGELA BALDWIN CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1093739575 | JAMES COWAN CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1063436236 | KAREN HENSLEY CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1609890888 | KIM HOTTLE CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
| 1558372300 | KIMBERLY D TRIBO CRNA Individual | Nurse Anesthetist, Certified Registered | 557 BROOKDALE DR STATESVILLE, NC 28677 (704) 873-5661 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760462196, enumerated in the NPI registry as an "organization" on January 20, 2006
The provider is located at 557 Brookdale Dr Statesville, Nc 28677 and the phone number is (704) 873-5661
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Absolute Total. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 34D0247318 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on January 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.