NPIMap

Organization Active NPI

Ashe Memorial Hospital Inc

  • Critical Access Hospital
  • Jefferson, NC
National Provider Identifier
1376671370
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H0099 Issued in NC
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
Mar 1, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Mr. Raymond Draper Williams II
Title
Ceo
Phone
(336) 846-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H0099 NC 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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230204000500 NC Part A Provider - Critical Access Hospital 7315912870 Receives reassigned benefits from 1 practitioner
Practice locations: Jefferson, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376671370. Details of each certification follow.

Hospital certification: CCN 341325

Legal name
ASHE MEMORIAL HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2007
Last certification
Jun 20, 2007
Beds
76
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 29, 1939 in NC
Enrollment address
200 Hospital Ave
Jefferson, NC 28640-9244
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ashe Memorial HospitalCCN 341325 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Charles Wright Individual Corporate OfficerCfo Jan 12, 2015 5%
Charles Bernard Jones Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Stephen Shoemaker Individual Corporate OfficerBoard Member Nov 18, 2007 5%
Charles Wade Jones Individual Corporate OfficerBoard Member Nov 21, 2008 5%
Martin George Little Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Karen Powell Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Jane Lonon Individual Corporate OfficerBoard Member Jan 19, 2022
William Brandon Vannoy Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Shana Anderson Individual W-2 Managing EmployeePatient Fin Serv Dir Jul 24, 1994
Joey Thore Individual Corporate OfficerBoard Member Nov 19, 1999
Donda Toney Individual Corporate DirectorDir Rev Cycle & Reimb Jun 28, 2021 5%
W-2 Managing EmployeeDir Rev Cycle & Reimb Jun 28, 2021 5%
Sue Hampton Individual Corporate OfficerBoard Member Nov 20, 2019
Horace Ernest Thompson Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Walter E Davis Individual Corporate OfficerBoard Member Jan 19, 2022 5%
Edward J Miller Individual Corporate OfficerBoard Member Nov 15, 1996 5%
Eisa Cox Individual Corporate OfficerBoard Member Jan 19, 2022
Greg Bower Individual Corporate OfficerBoard Member Mar 16, 2012

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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 28

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 28

Affiliated clinicians 212

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 212

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1376671370",
    "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": "2007-03-01",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "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_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NC",
            "license": "H0099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.