NPIMap

Organization Active NPI

Morehead Memorial Hospital

Doing business as Piedmont Surgical Associates

  • Surgery Physician
  • Eden, NC
National Provider Identifier
1457332702
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MOREHEAD MEMORIAL HOSPITAL
Doing business as
Piedmont Surgical Associates
Practice address
515 Thompson St
Suite B
Eden, NC 27288-5068
Phone
(336) 623-9118
Fax
(336) 623-1902
NPI assigned
Nov 11, 2005
Last updated
Apr 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Tamara L Hunt
Title
President
Phone
(336) 623-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

515 Thompson St
Suite B
Eden, NC 27288-5068

Mailing address

515 Thompson St
Suite B
Eden, NC 27288-5068
Phone (336) 623-9118

Other identifiers 4

IdentifierTypeStateIssuer
01563OtherNCBLUE CROSS BLUE SHIELD NC
026870OtherVAANTHEM
7901563MedicaidNC
CD8709OtherNCRAILROAD MEDICARE

Other names 1

  • Piedmont Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001498 NC Part B Supplier - Clinic/Group Practice 6204806342 Receives reassigned benefits from 25 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eden, NC; Mayodan, NC

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Morehead Memorial Hospita13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

515 Thompson St
Ste B
Eden, NC 27288
Phone (336) 623-9118

Practitioners & affiliated clinicians

Practitioners 10

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": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1457332702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 THOMPSON ST",
            "address_2": "SUITE B",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885068",
            "telephone_number": "336-623-9118",
            "fax_number": "336-623-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 THOMPSON ST",
            "address_2": "SUITE B",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885068",
            "telephone_number": "336-623-9118",
            "fax_number": "336-623-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-623-9711"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "01563",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "026870",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901563",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD8709",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piedmont Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.