NPIMap

Organization Active NPI

Morehead Memorial Hospital

Doing business as Morehead Urgent Care-West

  • Emergency Medical Services (Emergency Medicine) Physician
  • Mayodan, NC
National Provider Identifier
1194153569
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
MOREHEAD MEMORIAL HOSPITAL
Doing business as
Morehead Urgent Care-West
Practice address
6701B NC Hwy 135
Mayodan, NC 27027-8487
Phone
(336) 623-9711
NPI assigned
Oct 23, 2013
Last updated
Oct 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

6701B NC Hwy 135
Mayodan, NC 27027-8487

Mailing address

PO Box 488
Eden, NC 27289-0488
Phone (336) 627-0362

Other names 1

  • Morehead Urgent Care-West 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
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

515 Thompson St
Ste C
Eden, NC 27288
Phone (336) 623-1560

518 S Van Buren Rd
Ste 8
Eden, NC 27288
Phone (336) 623-8288

518 S Van Buren Rd
Ste 9
Eden, NC 27288
Phone (336) 623-8021

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1194153569",
    "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": "336-627-0362",
            "fax_number": "336-627-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701B NC HWY 135",
            "city": "MAYODAN",
            "state": "NC",
            "postal_code": "270278487",
            "telephone_number": "336-623-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CBO GROUP PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-623-9711"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morehead Urgent Care-West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayodan, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.