NPIMap

Organization Active NPI

Ashe Memorial Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Jefferson, NC
National Provider Identifier
1639279649
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ASHE MEMORIAL HOSPITAL INC
Practice address
200 Hospital Ave
Jefferson, NC 28640-9244
Phone
(336) 846-7101
Fax
(336) 846-0758
NPI assigned
Sep 22, 2006
Last updated
Aug 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Ms. Laura Lambeth
Title
Ceo
Phone
(336) 846-0790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

200 Hospital Ave
Jefferson, NC 28640-9244

Mailing address

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-7101

Other identifiers 3

IdentifierTypeStateIssuer
0081NOtherNCBLUE CROSS
3451325MedicaidNC
3461325MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071101000320 NC Part A Provider - Critical Access Hospital 7315912870 Practice locations: Jefferson, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639279649. Details of each certification follow.

Hospital certification: CCN 34Z325

Legal name
ASHE MEMORIAL HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Sep 29, 1939 in NC
Enrollment address
200 Hospital Ave
Jefferson, NC 28640-9244

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ashe Memorial Hosp ER7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Charles Wright Individual Corporate OfficerChief Financial Officer Jan 12, 2015 5%
Donnie Ray Johnson Individual Corporate OfficerBoard President Jan 1, 2019
Charles Bernard Jones Individual Corporate OfficerBoard Member Jan 1, 2019
Stephen Shoemaker Individual Corporate OfficerBoard Member Nov 16, 2007
Charles Wade Jones Individual Corporate OfficerBoard Member Nov 21, 2008 5%
Martin George Little Individual Corporate OfficerBoard Member Jan 1, 2019
Karen Powell Individual Corporate OfficerBoard Member Jan 1, 2019
Jane Lonon Individual Corporate OfficerBoard Secretary Nov 17, 2006
William Brandon Vannoy Individual Corporate OfficerBoard Member Jan 1, 2019
Shana Anderson Individual W-2 Managing EmployeeDirector Mar 6, 2001
Sue Hampton Individual Corporate OfficerBoard Member Nov 20, 2009
Novant Health, Inc. Organization, Winston Salem, NC Corporation Operational/Managerial Control Aug 1, 2013 100%
Edward J Miller Individual Corporate OfficerBoard Member Nov 15, 1996
Hobart Davis Individual Corporate OfficerBoard Vice President Nov 17, 1995
Greg Bower Individual Corporate OfficerBoard Treasurer Mar 16, 2012

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Amh Mountain Family Care CenterJefferson, NC, CCN 343425 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1639279649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101",
            "fax_number": "336-846-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101",
            "fax_number": "336-846-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHE MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "LAMBETH",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-846-0790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0081N",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3451325",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3461325",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, NC

Sources for this page

Verify at the official NPI Registry.