NPIMap

Organization Active NPI

Appalachian Mountain Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
National Provider Identifier
1154701415
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Practice address
711 New Leicester Hwy
Asheville, NC 28806-1048
Phone
(828) 253-3717
Fax
(828) 252-8072
NPI assigned
Jun 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Shantelle Simpson, RN, MSN
Title
President & Chief Executive Officer
Phone
(828) 202-5200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

711 New Leicester Hwy
Asheville, NC 28806-1048

Mailing address

PO Box 100181
Columbia, SC 29202-3141
Phone (828) 202-5200

Other identifiers 1

IdentifierTypeStateIssuer
1154701415MedicaidNC

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160715002052 NC Part A Provider - Federally Qualified Health Center (FQHC) 5395050827 Practice locations: Asheville, NC
O20160915000079 NC Part B Supplier - Clinic/Group Practice 5395050827 Receives reassigned benefits from 92 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Asheville, NC; Sylva, NC; Robbinsville, NC; Murphy, NC

Federally qualified health center certification: CCN 341046

Legal name
APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 19, 2016
Last certification
Jul 19, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 21, 2013 in NC
Enrollment address
711 New Leicester Hwy
Asheville, NC 28806-1048

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.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Anne M. Ramirez Individual Corporate DirectorBoard Member Aug 19, 2015
Christiana Tugman Individual Corporate DirectorBoard Member Jun 24, 2015
Operational/Managerial ControlBoard Member Jun 24, 2015
Neil W Garroway Individual Corporate DirectorBoard Member Sep 2, 2015
Operational/Managerial ControlBoard Member Sep 2, 2015
Shannon Cornelius Individual Corporate DirectorBoard Member Jan 2, 2019
Jesse T Michel Individual Corporate DirectorBoard Member Sep 2, 2015
Operational/Managerial ControlBoard Member Sep 2, 2015
Shantelle Simpson Individual Corporate OfficerCeo Jan 2, 2022
W-2 Managing EmployeeCeo Jan 2, 2022
Operational/Managerial ControlCeo Jan 2, 2022
Appalachian Mountain Community Health Centers Organization, Asheville, NC Corporation, Non-profit Operational/Managerial Control May 1, 2015 100%
Melba Millsaps Individual Corporate DirectorBoard Member Dec 1, 2017
Operational/Managerial ControlBoard Member Dec 1, 2017
Sharon West Individual Corporate DirectorBoard Member Dec 1, 2017
Operational/Managerial ControlBoard Member Dec 1, 2017
Micheal Woods Individual Corporate DirectorBoard Member May 1, 2015
Operational/Managerial ControlBoard Member May 1, 2015
Glenda P Odom Individual Corporate DirectorBoard Member Sep 2, 2015
Operational/Managerial ControlBoard Member Sep 2, 2015

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Appalachian Mountain Community Health CentersAsheville, NC, CCN 341033 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 21, 2013
Appalachian Mountain Community Health CentersSylva, NC, CCN 341044 Federally qualified health center Operational/Managerial Control (100%) May 1, 2015
Appalachian Mountain Community Health CentersRobbinsville, NC, CCN 341047 Federally qualified health center Operational/Managerial Control (100%) May 1, 2015
Appalachian Mountain Community Health CentersMurphy, NC, CCN 341052 Federally qualified health center Operational/Managerial Control (100%) May 1, 2015
May'S Care CenterAsheville, NC, CCN 341099 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 9, 2016

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1154701415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100181",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023141",
            "telephone_number": "828-202-5200",
            "fax_number": "828-479-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 NEW LEICESTER HWY",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288061048",
            "telephone_number": "828-253-3717",
            "fax_number": "828-252-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "SHANTELLE",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "828-202-5200",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154701415",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.