NPIMap

Organization Active NPI

Morehead Memorial Hospital

  • Family Medicine Physician
  • Eden, NC
National Provider Identifier
1760797294
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOREHEAD MEMORIAL HOSPITAL
Practice address
518 S Van Buren Rd
Suite 9
Eden, NC 27288-5033
Phone
(336) 623-9711
NPI assigned
Aug 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Tamara Hunt
Title
Vice President
Phone
(336) 623-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

518 S Van Buren Rd
Suite 9
Eden, NC 27288-5033

Mailing address

518 South Van Buren Road
Suite 9
Eden, NC 27288-5033
Phone (336) 623-9711

Other names 1

  • Morehead Family Medicine 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 Hospital13 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.

Locations

518 S Van Buren Rd
Ste 9
Eden, NC 27288
Phone (336) 623-8021

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1760797294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 SOUTH VAN BUREN ROAD",
            "address_2": "SUITE 9",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885033",
            "telephone_number": "336-623-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 S VAN BUREN RD",
            "address_2": "SUITE 9",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885033",
            "telephone_number": "336-623-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-623-9711"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morehead Family Medicine",
            "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 Aug 9, 2010; 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.