East Asheville Family Health Care P.a.
Organization Active NPI Family Medicine Physician · Black Mountain, NC
NPI 1386682367 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1386682367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 87151 (NC)
- Legal business name
- EAST ASHEVILLE FAMILY HEALTH CARE P.A.
- Practice address
- 997 Old US Hwy 70 W Ste a
Black Mountain, NC 28711-4505 - Phone
- (828) 298-7981
- Fax
- (828) 298-6010
- NPI assigned
- Jun 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Brenda Cheryl Fore, NP
- Title
- Owner
- Phone
- (828) 298-7981
Practitioners 15
-
Quentin Brice Butterfield, FNP-BC, RN
-
Brenda Cheryl Fore, FNP-BC
-
Clayton Shuford Moore, FNP-BC, NP-C
-
Anne Jennings Parker, FNP
-
Paula Denise Wilbanks, PMHNP
-
Hilma M Yu, M.D.
-
Keith Charles Damico, PAC
-
Jacqueline Frances Duncan, P.A-C
-
Melissa Sue Fowler, PAC
-
Jane Dee Hammond, PA-C
-
Catherine Weir Hart, LPN
-
Lee Anne Jackson, LPN
-
Christy Rene McCall, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2110696 | East Asheville Family Health Care, PA | Certificate of waiver | Mar 21, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100520000776 | NC | Part B Supplier - Clinic/Group Practice | 7810968781 |
Receives reassigned benefits from 7 practitioners Practice locations: Black Mountain, NC |
National Provider Directory
Locations
946 Tunnel Rd
Asheville, NC 28805
Phone (828) 298-7981
997 Old US Hwy 70 W
Black Mtn, NC 28711
Phone (828) 275-7981
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 87151 | NC | Yes |
Addresses
Primary practice location
997 Old US Hwy 70 W Ste a
Black Mountain, NC 28711-4505
Mailing address
997 Old US Hwy 70 W Ste a
Black Mountain, NC 28711-4505
Phone (828) 298-7981
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2344381 | Other | NC | MEDICARE |
| CH2430 | Other | NC | RAILROAD MEDICARE |
| 154699 | Other | NC | WELLCARE |
| 02742 | Other | NC | BCBS NC |
| 790294Q | Medicaid | NC | |
| X275 | Other | NC | BLUE MEDICARE |
Other providers in Black Mountain, NC
- Janice Leigh Donnell
- Diane S Douglas
- Dr Christina Smith Optometrist PA
- Drew David Schnyder P.a.
- James Howard Early
- Eckerd Corporation
- Karen Edey
- Sarah Lynn Eisenhauer
- Vernetta Lee Eleazer
- Edna Doreen English
All providers in Black Mountain, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.