NPIMap

Organization Active NPI

Henderson County Hospital Corporation

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Asheville, NC
National Provider Identifier
1053782318
Registry record updated Apr 21, 2021
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Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
HENDERSON COUNTY HOSPITAL CORPORATION
Practice address
21 Turtle Creek Dr
Asheville, NC 28803-3152
Phone
(828) 274-4555
NPI assigned
Oct 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Regina Burleson
Title
Credentialing
Phone
(828) 694-8350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

21 Turtle Creek Dr
Asheville, NC 28803-3152

Mailing address

21 Turtle Creek Dr
Asheville, NC 28803-3152
Phone (828) 274-4555

Other identifiers 1

IdentifierTypeStateIssuer
F380OtherNCMEDICARE

Other names 1

  • Southeastern Sports Medicine and Orthopedics Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160201002874 NC Part B Supplier - Clinic/Group Practice 8123938115 Receives reassigned benefits from 41 practitioners
Practice locations: Brevard, NC; Waynesville, NC; Pisgah Forest, NC; Hendersonville, NC; Asheville, NC; Arden, NC

Other NPIs with the same Medicare PAC ID 19

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

View all 19

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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
Pardee Home CareFlat Rock, NC, CCN 347028 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 24, 1998
Apr 24, 1998

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 270

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 270

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1053782318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TURTLE CREEK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033152",
            "telephone_number": "828-274-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TURTLE CREEK DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033152",
            "telephone_number": "828-274-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON COUNTY HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "BURLESON",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "828-694-8350"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F380",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Sports Medicine and Orthopedics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Southeastern Sports Medicine and Orthopedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.