NPIMap

Organization Active NPI

Appalachian Regional Medical Associates

Doing business as Watauga Internal Medicine

  • Internal Medicine Physician
  • Boone, NC
National Provider Identifier
1407093990
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33835 Issued in NC
Legal business name
APPALACHIAN REGIONAL MEDICAL ASSOCIATES
Doing business as
Watauga Internal Medicine
Practice address
136 Furman Rd
Suite 7
Boone, NC 28607-5038
Phone
(828) 262-0060
Fax
(828) 262-0062
NPI assigned
Jan 21, 2009
Last updated
Jan 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
APPALACHIAN REGIONAL MEDICAL ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Ms. Mary Etta Long
Title
Sr VP Medical Staff Relations
Phone
(828) 262-4133

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27800 NC
Internal Medicine Physician 207R00000X 28595 NC
Internal Medicine Physician 207R00000X 33835 NC Primary

Addresses

Primary practice location

136 Furman Rd
Suite 7
Boone, NC 28607-5038

Mailing address

155 Furman Rd
Suite 7
Boone, NC 28607-5049
Phone (828) 262-9125

Other identifiers 1

IdentifierTypeStateIssuer
5906476MedicaidNC

Other names 1

  • WATAUGA INTERNAL MEDICINE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

National Provider Directory

National Provider Directory
Tax ID family
Appalachian Regional Medical Associates Inc22 organizations share this tax ID, including this one
Part of
Appalachian Regional Medical Associates Inc

Other organizations with this tax ID 21

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

View all 21

Locations

136 Furman Rd
Boone, NC 28607
Phone (828) 262-0060

136 Furman Rd
Ste 6
Boone, NC 28607
Phone (828) 268-1185

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1407093990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FURMAN RD",
            "address_2": "SUITE 7",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075049",
            "telephone_number": "828-262-9125",
            "fax_number": "828-268-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 FURMAN RD",
            "address_2": "SUITE 7",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075038",
            "telephone_number": "828-262-0060",
            "fax_number": "828-262-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN REGIONAL MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL MEDICAL ASSOCIATES",
        "enumeration_date": "2009-01-21",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ETTA",
        "authorized_official_title_or_position": "SR VP MEDICAL STAFF RELATIONS",
        "authorized_official_telephone_number": "828-262-4133",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "27800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "28595",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "33835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906476",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WATAUGA INTERNAL MEDICINE",
            "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 Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.