NPIMap

Organization Active NPI

Morehead Memorial Hospital

Doing business as Morehead Urology Associates

  • Urology Physician
  • Eden, NC
National Provider Identifier
1174829204
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MOREHEAD MEMORIAL HOSPITAL
Doing business as
Morehead Urology Associates
Practice address
618 S Pierce St
Eden, NC 27288-5863
Phone
(336) 635-6804
Fax
(336) 627-0778
NPI assigned
Feb 8, 2011
Last updated
Sep 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Janet Woodall
Title
Group Practice Manager
Phone
(336) 623-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

618 S Pierce St
Eden, NC 27288-5863

Mailing address

PO Box 488
Eden, NC 27289-0488
Phone (336) 635-6804

Other names 1

  • Morehead Urology Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001498 NC Part B Supplier - Clinic/Group Practice 6204806342 Receives reassigned benefits from 25 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eden, NC; Mayodan, NC

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

618 S Pierce St
Eden, NC 27288
Phone (336) 394-3625

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1174829204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272890488",
            "telephone_number": "336-635-6804",
            "fax_number": "336-627-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S PIERCE ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885863",
            "telephone_number": "336-635-6804",
            "fax_number": "336-627-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "GROUP PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-623-9711"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morehead Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.