NPIMap

Organization Active NPI

Mountain Community Health Partnership Incorporated

Doing business as Micaville Health Center

  • Federally Qualified Health Center (FQHC)
  • Burnsville, NC
National Provider Identifier
1790408771
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED
Doing business as
Micaville Health Center
Mountain Community Health Partnership Incorporated
Practice address
621 Micaville Loop Ste 600
Burnsville, NC 28714-0828
Phone
(828) 675-4116
NPI assigned
Sep 23, 2022
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Timothy Evans
Title
Ceo
Phone
(828) 675-4116

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

621 Micaville Loop Ste 600
Burnsville, NC 28714-0828

Mailing address

PO Box 27
Bakersville, NC 28705-0027
Phone (828) 675-4116

Other names 2

  • Micaville Health Center Doing business as
  • Mountain Community Health Partnership Incorporated Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041208000049 NC Part B Supplier - Clinic/Group Practice 3678538683 Receives reassigned benefits from 38 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burnsville, NC; Spruce Pine, NC; Bakersville, NC

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1790408771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287050027",
            "telephone_number": "828-675-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MICAVILLE LOOP STE 600",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287140828",
            "telephone_number": "828-675-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-675-4116"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Micaville Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Community Health Partnership Incorporated",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.