NPIMap

Organization Active NPI

Hugh Chatham Memorial Hospital, Inc

Doing business as Foothills Family Medicine

  • Family Medicine Physician
  • Elkin, NC
National Provider Identifier
1508168808
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HUGH CHATHAM MEMORIAL HOSPITAL, INC
Doing business as
Foothills Family Medicine
Practice address
600 Chatham Medical Park
Elkin, NC 28621-2482
Phone
(336) 527-7383
NPI assigned
Nov 19, 2010
Last updated
Nov 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Authorized official

Name
Mrs. Mary F Blackburn
Title
Cpo
Phone
(336) 527-7463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

600 Chatham Medical Park
Elkin, NC 28621-2482

Mailing address

180 Parkwood Dr
Elkin, NC 28621-2430
Phone (336) 527-7463

Other names 1

  • Foothills Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040717000340 NC Part B Supplier - Clinic/Group Practice 2062311442 Receives reassigned benefits from 102 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ronda, NC; Mount Airy, NC; Jonesville, NC; Hays, NC; Elkin, NC; Boomer, NC; Dobson, NC

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Hugh Chatham Memorial Hos16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

600 Chatham Medical Park
Elkin, NC 28621
Phone (336) 527-7000

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1508168808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARKWOOD DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212430",
            "telephone_number": "336-527-7463",
            "fax_number": "336-527-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CHATHAM MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212482",
            "telephone_number": "336-527-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGH CHATHAM MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CPO",
        "authorized_official_telephone_number": "336-527-7463",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothills Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkin, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.