Watauga Medical Center, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

WATAUGA MEDICAL CENTER, INC

Doing business as

Watauga Medical Center, Inc Kidney Dialysis

Practice address

336 Deerfield Rd
Boone, NC 28607-5008

Phone

(828) 262-4100

Fax

(828) 262-4157

NPI assigned

Aug 17, 2006

Last updated

Jan 15, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

APPALACHIAN REGIONAL HEALTHCARE SYSTEMAs reported in NPPES

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

Authorized official

Name

Ms. Rayanna M Moore

Title

System Director Revenue Cycle

Phone

(282) 262-9110

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WATAUGA MEDICAL CENTER, INC KIDNEY DIALYSIS Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1457464745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FURMAN RD",
            "address_2": "SUITE 5",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075049",
            "telephone_number": "828-262-4100",
            "fax_number": "828-262-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 DEERFIELD RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075008",
            "telephone_number": "828-262-4100",
            "fax_number": "828-262-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATAUGA MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL HEALTHCARE SYSTEM",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "RAYANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "282-262-9110",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0054F",
            "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 MEDICAL CENTER, INC KIDNEY DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nephrology Physician in Boone, NC
• Providers in Boone, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.