Mountain Park Urgent Care & Walk-in Clinic, PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MOUNTAIN PARK URGENT CARE & WALK-IN CLINIC, PLLC

Practice address

90 E Main St Ste 2
Sylva, NC 28779-3030

Phone

(770) 265-8506

NPI assigned

Aug 12, 2019

Last updated

Jan 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura Southern Miller, NPNPI 1215377908

Title

Organizer

Phone

(770) 265-8506

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Laura Southern Miller, APRN

  • Nurse Practitioner
  • Sylva, NC
  • NPI 1215377908
  Medicare reassignment NPD Authorized official
• Cheryl N Owen, FNP

  • Family Nurse Practitioner
  • Sylva, NC
  • NPI 1235224692
  Medicare reassignment NPD
• Kathie B Supik, NP

  • Family Medicine Physician
  • Franklin, NC
  • NPI 1669952248
  Medicare reassignment NPD
• Christina Suzanne Wharton, FNP

  • Family Nurse Practitioner
  • Bryson City, NC
  • NPI 1902464126
  Medicare reassignment NPD

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1144876590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1039",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287791039",
            "telephone_number": "828-631-3181",
            "fax_number": "828-631-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E MAIN ST STE 2",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287793030",
            "telephone_number": "770-265-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PARK URGENT CARE & WALK-IN CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "SOUTHERN",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "770-265-8506",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mountainparkuc@gmail.com",
            "affiliation": "N",
            "address_1": "90 E Main St Ste 2",
            "city": "Sylva",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287793030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mountain Soul Counseling, PLLC
• Mountain Surgical Associates
• Mountain Trace Enterprise LLC (Mountain Trace Nursing Center)
• Mountain Trace Nursing Adk, LLC (Mountain Trace Rehabilitation and Nursing Center)

• Urgent Care Clinic/Center in Sylva, NC
• Providers in Sylva, NC by specialty
• Urgent Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.