NPIMap

Organization Active NPI

Morehead Memorial Hospital

Doing business as Family Practice of Eden

  • Family Medicine Physician
  • Eden, NC
National Provider Identifier
1629170147
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOREHEAD MEMORIAL HOSPITAL
Doing business as
Family Practice of Eden
Practice address
515 Thompson St
#D
Eden, NC 27288-5068
Phone
(336) 627-5178
NPI assigned
Sep 4, 2006
Last updated
Mar 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Tamara L. Hunt
Title
VP of Practice Management
Phone
(336) 623-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

515 Thompson St
#D
Eden, NC 27288-5068

Mailing address

515 Thompson St
#D
Eden, NC 27288-5068
Phone (336) 627-5178

Other identifiers 4

IdentifierTypeStateIssuer
0129XOtherNCBLUE CROSS
235082GOtherNCMEDICARE GRP PIN
890129XOtherNCMEDICAID GROUP # TERMINATED 3/1/09
5950636OtherNCMEDICAID GROUP # - EFFECTIVE 1/1/09

Other names 1

  • Family Practice of Eden Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001498 NC Part B Supplier - Clinic/Group Practice 6204806342 Receives reassigned benefits from 25 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eden, NC; Mayodan, NC

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Morehead Memorial Hospita13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1157328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1629170147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 THOMPSON ST",
            "address_2": "#D",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885068",
            "telephone_number": "336-627-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 THOMPSON ST",
            "address_2": "#D",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885068",
            "telephone_number": "336-627-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-04",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VP OF PRACTICE MANAGEMENT",
        "authorized_official_telephone_number": "336-623-9711"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0129X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP PIN",
            "identifier": "235082G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP # TERMINATED 3/1/09",
            "identifier": "890129X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP # - EFFECTIVE 1/1/09",
            "identifier": "5950636",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Practice of Eden",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.