NPIMap

Organization Active NPI

Fletcher Hospital Inc

Doing business as Adventhealth Multi-Specialty Clinic Foothills

  • Rural Health Clinic/Center
  • Columbus, NC
National Provider Identifier
1396573804
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FLETCHER HOSPITAL INC
Doing business as
Adventhealth Multi-Specialty Clinic Foothills
Practice address
130 Forest Glen Rd Ste B
Columbus, NC 28722-3456
Phone
(828) 894-5627
NPI assigned
Jul 25, 2024
Last updated
Jul 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Steven Burroughs
Title
Cfo
Phone
(828) 681-2102

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

130 Forest Glen Rd Ste B
Columbus, NC 28722-3456

Mailing address

130 Forest Glen Rd Ste B
Columbus, NC 28722-3456
Phone (828) 894-5627

Other names 1

  • ADVENTHEALTH MULTI-SPECIALTY CLINIC FOOTHILLS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250207001910 NC Part A Provider - Rural Health Clinic 5395658819 Practice locations: Columbus, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396573804. Details of each certification follow.

Rural health clinic certification: CCN 343463

Legal name
FLETCHER HOSPITAL INC
Doing business as
ADVENTHEALTH POLK
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 18, 2017
Last certification
Sep 22, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 26, 1920 in NC
Enrollment address
130 Forest Glen Rd
Ste B
Columbus, NC 28722-3456
Related CCNs
341322

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).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0889685Adventhealth Multi-Specialty Clinic Foothills130 Forest Glen Road, Suite B, Columbus, NC 28722Certificate of waiverJun 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Fletcher Hospital Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Sherri Holbert Individual Corporate DirectorDirector Aug 22, 2024
Fair Nabers Waggoner Individual Corporate DirectorDirector Aug 24, 2023
Alan Guyton, Jr Individual Corporate DirectorDirector Jun 4, 2020
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Steven Burroughs Individual Contracted Managing EmployeeCfo Mar 13, 2023
Corporate OfficerCfo Mar 13, 2023
Operational/Managerial ControlCfo Mar 13, 2023
Jeffrey B Garris Individual Corporate DirectorDirector Dec 8, 2022
Lewis Cass Sommerville Individual Corporate DirectorDirector Nov 15, 2023
Tristan Hamilton Individual Corporate DirectorDirector Feb 9, 2022
Michael Saunders Individual Corporate OfficerAssistant Secretary Feb 26, 2007
Leslie Louis Individual Corporate DirectorDirector Mar 1, 2012
Audrey E. Gregory Individual Corporate OfficerAssistant Secretary Aug 21, 2025
Corporate DirectorDirector Aug 21, 2025
Michael J Thompson Individual Corporate OfficerChairperson Jan 29, 2023
Corporate DirectorDirector Jan 29, 2023
Paul C Rathbun Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Adventist Health System Sunbelt Healthcare Corporation Organization, Columbus, NC Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 1, 2024 100%
Daniel Tryon Individual Contracted Managing EmployeeCeo Sep 22, 2025
Corporate OfficerCeo Sep 22, 2025
Operational/Managerial ControlCeo Sep 22, 2025
Amanda Brady Individual Corporate OfficerAssistsant Secretary Feb 27, 2020
Jeffrey L Coston Individual Corporate DirectorDirector Jun 7, 2018
Toni Berrios Individual Corporate OfficerAssistant Secretary Aug 25, 2022
Haney Vincent Individual Corporate DirectorAssistant Secretary Dec 9, 2021
David L Huffman Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Robert C Foltz Individual Corporate OfficerAssistant Secretary Jun 4, 2020
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Jan 1, 2006
Lowell Stewart Griffin Individual Corporate DirectorDirector Aug 24, 2023
Preston Blakely Individual Corporate DirectorDirector Aug 22, 2024
Beverly Morgan Individual Corporate OfficerAssistant Secretary Aug 21, 2025

Owners & managing parties with NPI records 3

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

Facilities with the same owner 85

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 85

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2024 Change of OwnershipThis provider was the buyer St. Luke's Hospital IncCCN 343463, NC, NPI 1558812594

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1396573804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FOREST GLEN RD STE B",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287223456",
            "telephone_number": "828-894-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FOREST GLEN RD STE B",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287223456",
            "telephone_number": "828-894-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLETCHER HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "BURROUGHS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "828-681-2102"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH MULTI-SPECIALTY CLINIC FOOTHILLS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, NC

Sources for this page

Verify at the official NPI Registry.