NPIMap

Organization Active NPI

Appalachian State University

  • Family Medicine Physician
  • Boone, NC
National Provider Identifier
1376794255
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
APPALACHIAN STATE UNIVERSITY
Practice address
1179 State Farm Rd
Boone, NC 28607-4943
Phone
(828) 262-8658
NPI assigned
Oct 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Mr. Bryan Belcher, MPH
Title
Interprofessional Clinic Director
Phone
(828) 262-8657

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C002267 NC
Registered Dietitian 133V00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Music TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225A00000X 000749-1 NY

Addresses

Primary practice location

1179 State Farm Rd
Boone, NC 28607-4943

Mailing address

1179 State Farm Rd Suite 132
Boone, NC 28608-2102
Phone (828) 262-8658

Other practice location 1

800 17th St NW
Hickory, NC 28601-3336
Phone (828) 827-6036

Other practice location 2

400 University Hall Drive
Room 120
Boone, NC 28608-2102
Phone (828) 262-7675

Other names 1

  • Appalachian Institute for Health and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051130000010 NC Part B Supplier - Clinic/Group Practice 8325068877 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boone, NC

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

114 Edwin Duncan Hall
Boone, NC 28608
Phone (828) 262-2185

1179 State Farm Rd
Ste 132
Boone, NC 28607
Phone (828) 262-8658

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1376794255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 STATE FARM RD SUITE 132",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286082102",
            "telephone_number": "828-262-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 STATE FARM RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074943",
            "telephone_number": "828-262-8658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 17th St NW",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286013336",
            "country_code": "US",
            "telephone_number": "828-827-6036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 University Hall Drive",
            "address_2": "Room 120",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286082102",
            "country_code": "US",
            "telephone_number": "828-262-7675",
            "fax_number": "828-262-6766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "APPALACHIAN STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "INTERPROFESSIONAL CLINIC DIRECTOR",
        "authorized_official_telephone_number": "828-262-8657",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002267",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Music Therapist",
            "state": "NY",
            "license": "000749-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appalachian Institute for Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.