Watauga Medical Center, Inc.
Organization Active NPI Cardiovascular Disease Physician · Jefferson, NC
NPI 1194069765 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1194069765
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- H0037 (NC)
- Legal business name
- WATAUGA MEDICAL CENTER, INC.
- Practice address
- 257 Medical Park Dr
Jefferson, NC 28640-9561 - Phone
- (336) 246-2404
- Fax
- (336) 246-2420
- NPI assigned
- Nov 20, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- APPALACHIAN REGIONAL HEALTHCARE SYSTEM
Authorized official
- Name
- Ms. Mary Etta Long
- Title
- Sr VP Medical Staff Relations
- Phone
- (828) 262-4133
Corporate family (same tax ID) 19
National Provider Directory
- Tax ID family
- Blue Ridge Physcial Therapy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | H0037 | NC | Yes |
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
- The Cardiology Center - Ashe
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Jefferson, NC
- Walgreen Co
- Walgreen Co
- Anna Gabriel Ward
- Watauga Medical Center Inc
- Watauga Medical Center, Inc.
- David Anthony Weisenhorn
- Western Carolina Eye Associates, PA
- Wilkes Radiology, PA
- Paula A Williams
- Emily Claire Wilson
All providers in Jefferson, NC · Cardiovascular Disease Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.