Crown Health Care PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CROWN HEALTH CARE PA

Practice address

1 Trade St
Granite Falls, NC 28630-1525

Phone

(828) 396-3136

Fax

(828) 396-3105

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Karen A. Stewart

Title

Administrative Assistant

Phone

(828) 465-9730

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Granite Falls Primary Care Physicians Doing business as

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1265516520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE TRADE STREET",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "28630",
            "telephone_number": "828-396-3136",
            "fax_number": "828-396-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRADE ST",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286301525",
            "telephone_number": "828-396-3136",
            "fax_number": "828-396-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN HEALTH CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "828-465-9730"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN8132",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN8132",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790148F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Falls Primary Care Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Connelly, LPCA
• Emily Blake Cook, FNP-C
• Heather Cooper, CADC
• Jessica Berry Crouch, PA
• Hannah Grace Crowder, OTR/L
• Evan Blake Deboard
• Debra G Hawn
• Macy Johnson Dickson, FNP
• Malinda Diffenbaugh, LPN
• Kerri Dilsaver, MA,CCC-SLP

• All providers in Granite Falls, NC
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.