NPIMap

Organization Active NPI

Sylva Clinical Associates, PA

  • Psychologist
  • Sylva, NC
National Provider Identifier
1326140609
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SYLVA CLINICAL ASSOCIATES, PA
Practice address
186 Medical Park LP
Suite 502
Sylva, NC 28779
Phone
(828) 568-5555
Fax
(828) 586-5555
NPI assigned
Sep 5, 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
Mrs. Chimene M Mathis
Title
Practice Manager
Phone
(828) 586-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

186 Medical Park LP
Suite 502
Sylva, NC 28779

Mailing address

186 Medical Park LP
Suite 502
Sylva, NC 28779
Phone (828) 568-5555

Other identifiers 2

IdentifierTypeStateIssuer
6001904MedicaidNC
0251COtherNCBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070302000124 NC Part B Supplier - Clinic/Group Practice 1759483159 Receives reassigned benefits from 8 practitioners
Practice locations: Sylva, NC

National Provider Directory

National Provider Directory

Locations

186 Medical Park Loop
Ste 502
Sylva, NC 28779
Phone (828) 568-5555

70 Westcare Dr
Sylva, NC 28779
Phone (828) 586-5555

70 Westcare Dr
Ste 402
Sylva, NC 28779
Phone (828) 586-5555

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326140609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 MEDICAL PARK LP",
            "address_2": "SUITE 502",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "28779",
            "telephone_number": "828-568-5555",
            "fax_number": "828-586-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 MEDICAL PARK LP",
            "address_2": "SUITE 502",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "28779",
            "telephone_number": "828-568-5555",
            "fax_number": "828-586-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLVA CLINICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "CHIMENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "828-586-5555",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001904",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0251C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.