Individual provider Active NPI

Alice Marie Horrell, DO

  • Emergency Medicine Physician
  • North Wilkesboro, NC
National Provider Identifier
1164685335
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2011-01878 Issued in NC
Practice address
1370 W D St
North Wilkesboro, NC 28659-3506
Phone
(336) 716-2255
NPI assigned
Jul 8, 2008
Last updated
Jan 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2011-01878 NC Primary

Addresses

Primary practice location

1370 W D St
North Wilkesboro, NC 28659-3506

Mailing address

PO Box 602598
Charlotte, NC 28260-2598
Phone (336) 716-2255

Other identifiers 1

IdentifierTypeStateIssuer
5920421MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131111000044 OR Practitioner - Emergency Medicine 7810156726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Cottage Grove Current Accepting new patients
Peacehealth CurrentSince Oct 20, 2018 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1515 Village Dr
Cottage Grove, OR 97424
Phone (541) 767-5200

400 9th St
Florence, OR 97439
Phone (541) 997-8412

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1164685335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602598",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602598",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORRELL",
        "first_name": "ALICE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2011-01878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5920421",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.