Boomer Medical Center, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BOOMER MEDICAL CENTER, INC.

Practice address

156 Boomer Community Center Rd
Boomer, NC 28606-9199

Phone

(336) 921-2273

Fax

(336) 921-2405

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Newman Pierce

Title

Administrator

Phone

(336) 921-2273

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Clifford Pinkerton, PA-C

  • Physician Assistant
  • North Wilkesboro, NC
  • NPI 1962520742
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1609942820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 238",
            "address_2": "156 BOOMER COMMUNITY CENTER RD",
            "city": "BOOMER",
            "state": "NC",
            "postal_code": "286069199",
            "telephone_number": "336-921-2273",
            "fax_number": "336-921-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 BOOMER COMMUNITY CENTER RD",
            "city": "BOOMER",
            "state": "NC",
            "postal_code": "286069199",
            "telephone_number": "336-921-2273",
            "fax_number": "336-921-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOMER MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "NEWMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-921-2273",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343930A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clay Stephen Camp, LPA
• Tevon Jerell Colbert
• Eckerd Youth Alternatives
• Michele Marie Edwards, PA-C
• Joshua Aaron Harless, OTR/L

• All providers in Boomer, NC
• Rural Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.