NPIMap

Organization Active NPI

Ashe Memorial Hospital Inc

  • Emergency Medicine Physician
  • Jefferson, NC
National Provider Identifier
1316045800
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ASHE MEMORIAL HOSPITAL INC
Practice address
200 Hospital Ave
Jefferson, NC 28640-9244
Phone
(336) 846-7101
Fax
(336) 846-0758
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Raymond Draper William II
Title
Ceo
Phone
(336) 846-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

200 Hospital Ave
Jefferson, NC 28640-9244

Mailing address

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-7101

Other identifiers 2

IdentifierTypeStateIssuer
8907617MedicaidNC
07617OtherNCBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041029000666 NC Part B Supplier - Clinic/Group Practice 7315912870 Receives reassigned benefits from 15 practitioners
4 other NPIs on this enrollment
Practice locations: Jefferson, 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 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Amh Mountain Family Care CenterJefferson, NC, CCN 343425 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2003

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316045800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101",
            "fax_number": "336-846-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101",
            "fax_number": "336-846-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHE MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAM",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "DRAPER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-846-0790",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8907617",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "07617",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.