NPIMap

Organization Active NPI

Hugh Chatham Memorial Hospital, Inc

Doing business as Tri-County Orthopedic & Sports Medicine

  • Orthopaedic Surgery Physician
  • Elkin, NC
National Provider Identifier
1275812273
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
HUGH CHATHAM MEMORIAL HOSPITAL, INC
Doing business as
Tri-County Orthopedic & Sports Medicine
Practice address
400 Johnson Ridge Medical Park
Elkin, NC 28621-2447
Phone
(336) 835-0300
NPI assigned
Aug 8, 2011
Last updated
Sep 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Mrs. Mary Frances Blackburn
Title
Chief Practice Officer
Phone
(336) 527-7463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

400 Johnson Ridge Medical Park
Elkin, NC 28621-2447

Mailing address

400 Johnson Ridge Medical Park
Elkin, NC 28621-2447
Phone (336) 835-0300

Other names 1

  • Tri-County Orthopedic & Sports Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040717000340 NC Part B Supplier - Clinic/Group Practice 2062311442 Receives reassigned benefits from 102 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ronda, NC; Mount Airy, NC; Jonesville, NC; Hays, NC; Elkin, NC; Boomer, NC; Dobson, NC
O20130503000077 NC DME Supplier - Physician - Unknown Physician SpecialtyDME Supplier - Physician - Orthopedic/Orthopedic Surgery 2062311442 Practice locations: Elkin, NC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Yadkin Valley Adult Med16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

156 Boomer Community Center Rd
Boomer, NC 28606
Phone (336) 921-2273

1428 N Bridge St
Elkin, NC 28621
Phone (336) 258-8105

201 Eldon Parks Dr
#A
Elkin, NC 28621
Phone (336) 835-0016

201 Eldon Parks Dr
#B
Elkin, NC 28621
Phone (336) 835-2349

520 Chatham Medical Park
Elkin, NC 28621
Phone (336) 835-1324

700 Johnson Ridge Rd
Elkin, NC 28621
Phone (336) 527-7090

800 Chatham Medical Park
Elkin, NC 28621
Phone (336) 526-4500

423 S South St
Ste 201
Mount Airy, NC 27030
Phone (336) 527-7463

22 Training Center Rd
Woodlawn, VA 24381
Phone (276) 266-3134

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alleghany County Memorial Hospital IncSparta, NC, CCN 34Z320 Hospital Other Feb 2, 2018
Alleghany Memorial HospitalSparta, NC, CCN 341320 Hospital 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control
Other		 Feb 2, 2018
Feb 2, 2018
Feb 2, 2001
Mountain Valley Hospice & Palliative CareDobson, NC, CCN 341546 Hospice 5% Or Greater Direct Ownership Interest (50%) Oct 1, 2005
Mountain Valley Hospice & Palliative CareGalax, VA, CCN 491580 Hospice 5% Or Greater Direct Ownership Interest (50%) Oct 1, 2005
Alleghany Memorial HospitalSparta, NC, CCN 343476 Rural health clinic Other Feb 2, 2018

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 101

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 101

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1275812273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHNSON RIDGE MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212447",
            "telephone_number": "336-835-0300",
            "fax_number": "336-527-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHNSON RIDGE MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212447",
            "telephone_number": "336-835-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGH CHATHAM MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "CHIEF PRACTICE OFFICER",
        "authorized_official_telephone_number": "336-527-7463",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-County Orthopedic & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.