NPIMap

Organization Active NPI

Hospice of Surry County, Inc

Doing business as Mountain Valley

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Galax, VA
National Provider Identifier
1033485073
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
HOSPICE OF SURRY COUNTY, INC
Doing business as
Mountain Valley
Mountain Valley Hospice and Palliative Care
Practice address
7599 Carrollton Pike Ste C
Galax, VA 24333-4269
Phone
(276) 728-1030
Fax
(276) 728-1041
NPI assigned
Mar 23, 2012
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Mrs. Tracey Smith Dobson, RN, BSN
Title
Interim Ceo
Phone
(336) 789-2922

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X Primary

Addresses

Primary practice location

7599 Carrollton Pike Ste C
Galax, VA 24333-4269

Mailing address

PO Box 325
Dobson, NC 27017-0325
Phone (336) 789-2922

Other practice location 1

730 E Church St Ste 13
Martinsville, VA 24112-3151
Phone (276) 728-1030

Other names 2

  • Mountain Valley Doing business as
  • Mountain Valley Hospice and Palliative Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081007000249 VA Part B Supplier - Clinic/Group Practice 2961448741 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Galax, VA; Martinsville, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Surry County Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

968 N Bridge St
Elkin, NC 28621

220 Market View Dr
Ste C
Kernersville, NC 27284

141 Spruce Pine Way
King, NC 27021
Phone (336) 789-2922

129 Veterans Dr
Pilot Mountain, NC 27041
Phone (336) 368-1260

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mountain ValleyFort Mill, SC, CCN 421654 Hospice 5% Or Greater Indirect Ownership Interest (8%) Dec 11, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1033485073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "DOBSON",
            "state": "NC",
            "postal_code": "270170325",
            "telephone_number": "336-789-2922",
            "fax_number": "336-789-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7599 CARROLLTON PIKE STE C",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243334269",
            "telephone_number": "276-728-1030",
            "fax_number": "276-728-1041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 E Church St Ste 13",
            "address_purpose": "LOCATION",
            "city": "Martinsville",
            "state": "VA",
            "postal_code": "241123151",
            "country_code": "US",
            "telephone_number": "276-728-1030",
            "fax_number": "276-728-1041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOSPICE OF SURRY COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "DOBSON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "336-789-2922",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Valley Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Valley Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galax, VA

Sources for this page

Verify at the official NPI Registry.