NPIMap

Organization Active NPI

Southmountain Children and Family Services

Doing business as Children's Advocacy Center of the Blue Ridge

  • Family Nurse Practitioner
  • Boone, NC
National Provider Identifier
1033462148
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES
Doing business as
Children's Advocacy Center of the Blue Ridge
Practice address
8076 Hwy 105 South
Boone, NC 28607
Phone
(828) 963-9777
NPI assigned
Oct 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William Jernigan
Title
Executive Director
Phone
(828) 584-1105

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

8076 Hwy 105 South
Boone, NC 28607

Mailing address

PO Box 3387
Morganton, NC 28680-3387
Phone (828) 391-2803

Other practice location 1

105 Niley Cook Rd
Blowing Rock, NC 28605-9553
Phone (828) 584-1105

Other practice location 2

105 Niley Cook Rd
Blowing Rock, NC 28605-9553
Phone (828) 584-1105

Other names 1

  • Children's Advocacy Center of the Blue Ridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southmountain Children and Family Services24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

105 Niley Cook Rd
Blowing Rock, NC 28605
Phone (828) 278-9763

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26108/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1033462148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3387",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286803387",
            "telephone_number": "828-391-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8076 HWY 105 SOUTH",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-963-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Niley Cook Rd",
            "address_purpose": "LOCATION",
            "city": "Blowing Rock",
            "state": "NC",
            "postal_code": "286059553",
            "country_code": "US",
            "telephone_number": "828-584-1105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Niley Cook Rd",
            "address_purpose": "LOCATION",
            "city": "Blowing Rock",
            "state": "NC",
            "postal_code": "286059553",
            "country_code": "US",
            "telephone_number": "828-584-1105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHMOUNTAIN CHILDREN AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "828-584-1105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Advocacy Center of the Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Advocacy Center of the Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.