Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mooresville Ppm, LLC

Organization Interventional Cardiology Physician · NPI 1003567082

Mooresville Ppm, LLC is an Interventional Cardiology Physician in Statesville, North Carolina. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1424 Fern Creek Dr Ste D
Statesville, NC 28625-9376
Phone: (704) 878-2058
Fax: (704) 872-6576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X

Record details

NPI number1003567082
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMooresville Ppm, LLC
Authorized official Jennifer Jackson — Sr Dir Prov Enroll & Onboarding · (615) 465-3334
Other names Lake Norman Medical Group Heart & Vascular Statesville
NPI enumeratedJanuary 12, 2022
Last updated in NPPESJanuary 12, 2022
Certification dateJanuary 12, 2022
Mailing addressPo Box 689022, Franklin, TN 37068-9022

Other providers in Statesville