Organization Active NPI

Highland Medical Associates, P.a.

  • Medical Physician Assistant
  • Hendersonville, NC
National Provider Identifier
1598891665
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103090 Issued in NC
Legal business name
HIGHLAND MEDICAL ASSOCIATES, P.A.
Practice address
165 Coolridge Street
Hendersonville, NC 28792-2767
Phone
(828) 694-3939
Fax
(828) 692-0533
NPI assigned
Feb 25, 2007
Last updated
Dec 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Mr. Gregory Robert Mesa, PA-C
Title
Partner/Officer
Phone
(828) 694-3939

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 103090 NC Primary

Addresses

Primary practice location

165 Coolridge Street
Hendersonville, NC 28792-2767

Mailing address

165 Coolridge Street
Hendersonville, NC 28792-2767
Phone (828) 694-3939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000972 NC Part A Provider - Rural Health Clinic 0941101018 Practice locations: Hendersonville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598891665. Details of each certification follow.

Rural health clinic certification: CCN 348944

Legal name
HIGHLAND MEDICAL ASSOCIATES, P.A.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 25, 2004
Last certification
Sep 1, 2021
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Sep 17, 2003 in NC
Enrollment address
165 Coolridge St
Hendersonville, NC 28792-2767

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1049973Highland Medical Associates165 Coolridge Street, Hendersonville, NC 28792Certificate of waiverSep 1, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Todd I Stone Individual 5% Or Greater Direct Ownership InterestOwner Sep 17, 2003
Corporate DirectorOwner Jan 20, 2004
W-2 Managing EmployeeOwner Mar 24, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 4

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": "1172361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1598891665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COOLRIDGE STREET",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922767",
            "telephone_number": "828-694-3939",
            "fax_number": "828-692-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 COOLRIDGE STREET",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922767",
            "telephone_number": "828-694-3939",
            "fax_number": "828-692-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND MEDICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-25",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "MESA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER/OFFICER",
        "authorized_official_telephone_number": "828-694-3939",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.