Tanglewood Park Physicians, PLLC in Clemmons, NC
This organization bills under NPI 1093286379, an organization record issued on Dec 11, 2018 with the primary taxonomy Emergency Medicine Physician. Each clinician who works there has their own NPI and license.
Organization recordNPPES, Aug 2026
1093286379
- Legal name
- Tanglewood Park Physicians, PLLC
- Entity
- Type 2 · organization
- Primary taxonomy
- Emergency Medicine Physician 207P00000X
- Practice location
- 6915 VILLAGE MEDICAL CIR, Clemmons, NC 27012
- Phone
- 336-893-1000
- Mailing address
- Belfast, ME
- Enumerated
- Dec 11, 2018
- Record updated
- Feb 5, 2020
- Authorized official
- Director Of Credentialing (title as filed)
20 clinicians CMS lists with Tanglewood Park Physicians in Clemmons
- Yousif Alkadhi, MDEmergency Medical Services (Emergency Medicine) Physician1508093949
- Gabriel Autry, MDEmergency Medicine Physician1700457652
- James Balvich, MDInternal Medicine Physician1427020163
- Robert Bostic, PAPhysician Assistant1093750093
- John Bream, MDFamily Medicine Physician1811124266
- Elizabeth Caudill, MDEmergency Medicine Physician1114381738
- Teresa Crite, FNPFamily Nurse Practitioner1013766104
- William Cupo, MDEmergency Medicine Physician1073509618
- Taylor Day, DOEmergency Medicine Physician1104482694
- John Dery, DOEmergency Medicine Physician1720101561
- Jesse EllsworthEmergency Medicine Physician1063827582
- William Goncharow, DOEmergency Medicine Physician1407113103
- Michael Halsey, MDEmergency Medicine Physician1306284773
- William HilbertNurse Practitioner1972393130
- Bendu HillMedical Physician Assistant1497615074
- David Holder, MDEmergency Medicine Physician1619140449
- Reuben Horace, DOEmergency Medicine Physician1942940630
- Stephanie JassoAcute Care Nurse Practitioner1952268278
- Kelsey Jones, APRNNurse Practitioner1952938466
- Justin Kan, MDEmergency Medicine Physician1649412321
Source: CMS Doctors and Clinicians group affiliations, matched by practice name and city.
Checking an organization
- Confirm the business with the North Carolina secretary of state.
- Check the HHS-OIG exclusion list for the organization.
- Verify each clinician on their own record and the state license search.
Common questions
Why is the mailing address in Maine?
The mailing address in the record (Belfast, ME) is where the organization receives mail. Care is given at the practice location in Clemmons.
Is an organization NPI a license?
No. An NPI identifies who bills. Facilities and the clinicians who work there are licensed separately by the state.
Source: CMS National Plan and Provider Enumeration System (NPPES), monthly file of Aug 9, 2026 (NPPES files on CMS.gov). An NPI identifies who bills; it is not a license.