NPIMap

Organization Active NPI

Appalachian Regional Medical Associates

Doing business as Elk River Medical Associates

  • Family Medicine Physician
  • Banner Elk, NC
National Provider Identifier
1487891933
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33815 Issued in NC
Legal business name
APPALACHIAN REGIONAL MEDICAL ASSOCIATES
Doing business as
Elk River Medical Associates
Practice address
150 Park Ave
Banner Elk, NC 28604-6604
Phone
(828) 262-9127
Fax
(828) 268-0742
NPI assigned
Jan 20, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33815 NC Primary
Internal Medicine Physician 207R00000X 31158 NC

Addresses

Primary practice location

150 Park Ave
Banner Elk, NC 28604-6604

Mailing address

155 Furman Rd
Suite 7
Boone, NC 28607-5049
Phone (828) 262-9127

Other identifiers 1

IdentifierTypeStateIssuer
5907786MedicaidNC

Other names 1

  • ELK RIVER MEDICAL ASSOCIATES 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 Associates22 organizations share this tax ID, including this one
Part of
Appalachian Regional Medical Associates

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1487891933",
    "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": "828-262-9127",
            "fax_number": "828-268-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PARK AVE",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286046604",
            "telephone_number": "828-262-9127",
            "fax_number": "828-268-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN REGIONAL MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL MEDICAL ASSOCIATES",
        "enumeration_date": "2009-01-20",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "33815",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "31158",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907786",
            "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": "ELK RIVER MEDICAL ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Banner Elk, 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.