Individual provider Active NPI

Elisabeth Ann Stump, PA

  • Physician Assistant
  • Hickory, NC
National Provider Identifier
1255826947
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00010-08 Issued in NC
Practice address
1501 Tate Blvd SE Ste 201
Hickory, NC 28602
Phone
(828) 322-4140
Fax
(828) 322-3767
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00010-08 NC Primary

Addresses

Primary practice location

1501 Tate Blvd SE Ste 201
Hickory, NC 28602

Mailing address

1501 Tate Blvd SE Ste 201
Hickory, NC 28602-1385
Phone (828) 322-4140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918000619 NC Practitioner - Physician Assistant 2264783042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Regional Medical Associates IncGroup PAC ID 5799877817, 147 clinicians

Practice addresses (Care Compare)

211 Milton Brown Heirs Rd
Boone, NC 28607-8708
Phone (828) 265-2159

336 Deerfield Rd
Boone, NC 28607-5008
Phone (828) 262-4100

935 State Farm Rd
Suite 101
Boone, NC 28607-4948
Phone (828) 264-5150

965 State Farm Rd
Boone, NC 28607-4948
Phone (828) 264-2340

Hospital & facility affiliations

  • Watauga Medical Center Hospital, Boone, NC, CCN 340051
  • Charles a Cannon Jr Memorial Hospital Hospital, Linville, NC, CCN 341323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00010-08NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: estump528333@direct.unc.nchie.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1255826947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-322-4140",
            "fax_number": "828-322-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "28602",
            "telephone_number": "828-322-4140",
            "fax_number": "828-322-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMP",
        "first_name": "ELISABETH",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "00010-08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.