NPIMap

Organization Active NPI

Watauga Medical Center, Inc.

Doing business as Seby B. Jones Regional Cancer Center - Ashe

  • Hematology & Oncology Physician
  • Jefferson, NC
National Provider Identifier
1174867667
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
H0037 Issued in NC
Legal business name
WATAUGA MEDICAL CENTER, INC.
Doing business as
Seby B. Jones Regional Cancer Center - Ashe
Practice address
257 Medical Park Dr
Jefferson, NC 28640-9561
Phone
(336) 246-2404
Fax
(336) 246-2420
NPI assigned
Nov 21, 2012
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
APPALACHIAN REGIONAL HEALTH CARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Ms. Mary Etta Long
Title
Sr VP Medical Staff Relations
Phone
(828) 262-4133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X H0037 NC Primary

Addresses

Primary practice location

257 Medical Park Dr
Jefferson, NC 28640-9561

Mailing address

155 Furman Rd
Suite 101
Boone, NC 28607-5049
Phone (828) 262-4438

Other names 1

  • Seby B. Jones Regional Cancer Center - Ashe Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Watauga Medical Ctr Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1174867667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FURMAN RD",
            "address_2": "SUITE 101",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075049",
            "telephone_number": "828-262-4438",
            "fax_number": "828-262-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 MEDICAL PARK DR",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409561",
            "telephone_number": "336-246-2404",
            "fax_number": "336-246-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATAUGA MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL HEALTH CARE SYSTEM",
        "enumeration_date": "2012-11-21",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ETTA",
        "authorized_official_title_or_position": "SR VP MEDICAL STAFF RELATIONS",
        "authorized_official_telephone_number": "828-262-4133",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "H0037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Seby B. Jones Regional Cancer Center - Ashe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.