NPIMap

Organization Active NPI

Northern Hospital District of Surry County

Doing business as Northern Urgent Care

  • Rural Health Clinic/Center
  • Mount Airy, NC
National Provider Identifier
1720839228
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NORTHERN HOSPITAL DISTRICT OF SURRY COUNTY
Doing business as
Northern Urgent Care
Practice address
119 Welch Rd Ste a
Mount Airy, NC 27030-5274
Phone
(336) 719-7200
Fax
(336) 786-3737
NPI assigned
Apr 1, 2024
Last updated
Jun 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Rachel Hiatt
Title
Director, Central Billing
Phone
(336) 786-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

119 Welch Rd Ste a
Mount Airy, NC 27030-5274

Mailing address

PO Box 1267
Mount Airy, NC 27030-1267
Phone (336) 783-8911

Other names 1

  • Northern Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200708003351 NC Part B Supplier - Clinic/Group Practice 7517380553 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Airy, NC
O20241018001607 NC Part A Provider - Rural Health Clinic 7517380553 Practice locations: Mount Airy, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720839228. Details of each certification follow.

Rural health clinic certification: CCN 348996

Legal name
NORTHERN HOSPITAL DISTRICT OF SURRY COUNTY
Doing business as
NORTHERN URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2024
Last certification
Dec 6, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 6, 2020 in NC
Enrollment address
119 Welch Rd
Ste a
Mount Airy, NC 27030-5274

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Derek White Individual Corporate DirectorDirector, Operational Finance Jan 1, 1996 100%
Operational/Managerial ControlDirector, Operational Finance Jan 1, 1996 100%
Andrea Hickling Individual Corporate OfficerCfo Aug 1, 2013 100%
Northern Hospital District of Surry County Organization, Mount Airy, NC Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2020 100%

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 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1720839228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270301267",
            "telephone_number": "336-783-8911",
            "fax_number": "336-786-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WELCH RD STE A",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305274",
            "telephone_number": "336-719-7200",
            "fax_number": "336-786-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN HOSPITAL DISTRICT OF SURRY COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "HIATT",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR, CENTRAL BILLING",
        "authorized_official_telephone_number": "336-786-8452"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.