NPIMap

Organization Active NPI

Mountain Community Health Partnership Incorporated

  • Federally Qualified Health Center (FQHC)
  • Bakersville, NC
National Provider Identifier
1043315054
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
CHC24141 Issued in NC
Legal business name
MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED
Practice address
86 N Mitchell Ave
Bakersville, NC 28705-6502
Phone
(828) 688-2104
Fax
(844) 772-0832
NPI assigned
Sep 14, 2006
Last updated
Mar 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Mr. Timothy Evans
Title
Ceo
Phone
(828) 675-4116

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X CHC24141 NC Primary

Addresses

Primary practice location

86 N Mitchell Ave
Bakersville, NC 28705-6502

Mailing address

86 N Mitchell Ave
P.O. Box 27
Bakersville, NC 28705-6502
Phone (828) 688-2104

Other practice location 1

395 Burnsville School Rd
Burnsville, NC 28714-8618
Phone (828) 682-2104

Other practice location 2

139 S Toe School Rd
Burnsville, NC 28714-8551
Phone (828) 688-2104

Other practice location 3

910 Cane River School Rd
Burnsville, NC 28714-8302
Phone (828) 688-2104

Other practice location 4

264 Mayland Dr
Spruce Pine, NC 28777-8434
Phone (828) 688-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041208000049 NC Part B Supplier - Clinic/Group Practice 3678538683 Receives reassigned benefits from 38 practitioners
6 other NPIs on this enrollment
Practice locations: Burnsville, NC; Spruce Pine, NC; Bakersville, NC
O20120828000049 NC Part A Provider - Federally Qualified Health Center (FQHC) 3678538683 Practice locations: Bakersville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043315054. Details of each certification follow.

Federally qualified health center certification: CCN 341982

Legal name
MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED
Doing business as
BAKERSVILLE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 7, 2012
Last certification
Sep 7, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1974 in NC
Enrollment address
86 North Mitchell Ave
Bakersville, NC 28705-6502

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0247463Mountain Community Health Partnership - Spruce86 North Mitchell Avenue, Bakersville, NC 28705Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

139 S Toe School Rd
Burnsville, NC 28714
Phone (828) 688-2104

285 Georges Fork Rd
Burnsville, NC 28714
Phone (828) 682-2281

621 Micaville Loop
Ste 600
Burnsville, NC 28714
Phone (828) 675-0001

910 Cane River School Rd
Burnsville, NC 28714
Phone (828) 688-2104

264 Mayland Dr
Spruce Pine, NC 28777
Phone (828) 688-2104

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
United Community Bank Organization, Bakersville, NC Financial institution 5% Or Greater Mortgage Interest Apr 12, 2012 17.42%
Angela Michelle Wilson Individual Operational/Managerial ControlCredentialing Specialist Nov 17, 2022 100%
Timothy a Evans Individual Operational/Managerial ControlCeo Jul 1, 2023 100%
April Yolei Briggs Individual Operational/Managerial ControlCfo Nov 13, 2024 100%

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1043315054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 N MITCHELL AVE",
            "address_2": "P.O. BOX 27",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287056502",
            "telephone_number": "828-688-2104",
            "fax_number": "844-772-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 N MITCHELL AVE",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287056502",
            "telephone_number": "828-688-2104",
            "fax_number": "844-772-0832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 Burnsville School Rd",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "NC",
            "postal_code": "287148618",
            "country_code": "US",
            "telephone_number": "828-682-2104",
            "fax_number": "844-772-0832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "139 S Toe School Rd",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "NC",
            "postal_code": "287148551",
            "country_code": "US",
            "telephone_number": "828-688-2104",
            "fax_number": "844-772-0832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Cane River School Rd",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "NC",
            "postal_code": "287148302",
            "country_code": "US",
            "telephone_number": "828-688-2104",
            "fax_number": "844-772-0832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "264 Mayland Dr",
            "address_purpose": "LOCATION",
            "city": "Spruce Pine",
            "state": "NC",
            "postal_code": "287778434",
            "country_code": "US",
            "telephone_number": "828-688-2104",
            "fax_number": "844-772-0832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-675-4116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NC",
            "license": "CHC24141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersville, NC

Sources for this page

Verify at the official NPI Registry.