Organization Active NPI

WNC Healing Collaborative, PLLC

  • Primary Care Clinic/Center
  • Marshall, NC
National Provider Identifier
1134837198
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WNC HEALING COLLABORATIVE, PLLC
Practice address
32 N Main St Unit 1
Marshall, NC 28753-0317
Phone
(828) 201-2758
Fax
(877) 371-6918
NPI assigned
Nov 9, 2022
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Shannon O'Conner, FNPNPI 1902190416
Title
Ceo
Phone
(828) 201-2758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

32 N Main St Unit 1
Marshall, NC 28753-0317

Mailing address

32 N Main St Unit 1
Marshall, NC 28753-0317
Phone (828) 201-2758

Other identifiers 1

IdentifierTypeStateIssuer
1902190416MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@wnchealing.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230103000188 NC Part B Supplier - Clinic/Group Practice 2264802552 Receives reassigned benefits from 1 practitioner
Practice locations: Marshall, NC

National Provider Directory

National Provider Directory

Locations

3377 Broad St
Clyde, NC 28721
Phone (828) 201-2758

32 N Main St
Marshall, NC 28753

32 N Main St
Unit 1
Marshall, NC 28753
Phone (828) 201-2758

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27541/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1134837198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST UNIT 1",
            "city": "MARSHALL",
            "state": "NC",
            "postal_code": "287530317",
            "telephone_number": "828-201-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST UNIT 1",
            "city": "MARSHALL",
            "state": "NC",
            "postal_code": "287530317",
            "telephone_number": "828-201-2758",
            "fax_number": "877-371-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WNC HEALING COLLABORATIVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "O'CONNER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-201-2758",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902190416",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@wnchealing.com",
            "affiliation": "N",
            "address_1": "32 N Main St Unit 1",
            "city": "Marshall",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287530317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshall, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.