NPIMap

Appalachian Regional Medical Associates

Organization Active NPI Family Medicine Physician · Boone, NC

NPI 1508003203 · NPPES record last updated Jan 17, 2025

Key facts

NPI
1508003203
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
200300057 (NC)
Legal business name
APPALACHIAN REGIONAL MEDICAL ASSOCIATES
Practice address
400 Shadowline Dr
Suite104
Boone, NC 28607-5089
Phone
(828) 268-1187
Fax
(828) 262-9728
NPI assigned
Jan 16, 2009
Organization subpart
Yes
Parent organization (as reported)
APPALACHIAN REGIONAL MEDICAL ASSOICATES

Authorized official

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

Corporate family (same tax ID) 21

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

National Provider Directory

Tax ID family
Appalachian Regional Medical Associates Inc (22 organizations share this tax ID)
Part of
Appalachian Regional Medical Associates Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X 200300057 NC Yes

Addresses

Primary practice location

400 Shadowline Dr
Suite104
Boone, NC 28607-5089

Mailing address

166 Doctors Dr
Boone, NC 28607-5000
Phone (828) 262-9125

Other identifiers

IdentifierTypeStateIssuer
5907784MedicaidNC

Other names

  • APPALACHIAN REGIONAL ADULT AND FAMILY MEDICINE Doing business as

Electronic endpoints

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 17, 2025.

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1508003203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 DOCTORS DR",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075000",
            "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": "400 SHADOWLINE DR",
            "address_2": "SUITE104",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075089",
            "telephone_number": "828-268-1187",
            "fax_number": "828-262-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN REGIONAL MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APPALACHIAN REGIONAL MEDICAL ASSOICATES",
        "enumeration_date": "2009-01-16",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200300057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907784",
            "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": "APPALACHIAN REGIONAL ADULT AND FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, NC

All providers in Boone, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.