NPIMap

Organization Active NPI

Mission Community Anesthesiology Specialists LLC

  • Urology Physician
  • Asheville, NC
National Provider Identifier
1235609470
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Practice address
100 Victoria Rd
Asheville, NC 28801-4812
Phone
(828) 213-1740
NPI assigned
Nov 30, 2018
Last updated
Dec 5, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Authorized official

Name
Marilyn Tatham, DO
Title
Provider Enrollment Manager
Phone
(828) 651-6595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

100 Victoria Rd
Asheville, NC 28801-4812

Mailing address

PO Box 603366
Charlotte, NC 28260-3366
Phone (828) 213-1500

Other practice location 1

87 Medical Park Dr Ste B
Brevard, NC 28712-3210
Phone (828) 213-1740

Other practice location 2

149 W Parker Rd
Morganton, NC 28655-4673
Phone (828) 213-1740

Other practice location 3

87 Medical Park Dr Ste A
Brevard, NC 28712-3210
Phone (828) 213-1740

Other practice location 4

472 Rankin Dr
Marion, NC 28752-6568
Phone (828) 213-1740

Other practice location 5

2100 Ridgefield Blvd
Asheville, NC 28806-2343
Phone (828) 213-1740

Other practice location 6

209 Hospital Dr
Highlands, NC 28741-7623
Phone (828) 213-1740

Other practice location 7

190 Hospital Dr
Highlands, NC 28741-7600
Phone (828) 213-1740

Other practice location 8

209 Hospital Dr Ste 303
Highlands, NC 28741-7616
Phone (828) 213-1740

Other identifiers 1

IdentifierTypeStateIssuer
02CG9OtherNCBC/BS NC

Other names 1

  • Urology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160426001883 NC Part B Supplier - Clinic/Group Practice 9537468574 Receives reassigned benefits from 953 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory
Tax ID family
Mission Health Community Multispecialty Providers LLC23 organizations share this tax ID, including this one
Part of
Mission Health Community Multispecialty Providers LLC

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1235609470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603366",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603366",
            "telephone_number": "828-213-1500",
            "fax_number": "828-681-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VICTORIA RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014812",
            "telephone_number": "828-213-1740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 Medical Park Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Brevard",
            "state": "NC",
            "postal_code": "287123210",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "149 W Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554673",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 Medical Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Brevard",
            "state": "NC",
            "postal_code": "287123210",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "472 Rankin Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "NC",
            "postal_code": "287526568",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Ridgefield Blvd",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288062343",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "209 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Highlands",
            "state": "NC",
            "postal_code": "287417623",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "190 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Highlands",
            "state": "NC",
            "postal_code": "287417600",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "209 Hospital Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Highlands",
            "state": "NC",
            "postal_code": "287417616",
            "country_code": "US",
            "telephone_number": "828-213-1740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "TATHAM",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "828-651-6595",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC",
            "identifier": "02CG9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Urology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.