Yancey County Primary Care Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

YANCEY COUNTY PRIMARY CARE CENTER

Practice address

202 Medical Campus Dr.
Burnsville, NC 28714

Phone

(828) 682-6118

Fax

(828) 682-6262

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lynda Kinnane

Title

Interim Health Director

Phone

(828) 765-9081

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Toe River Health District Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Toe River Health District

  • State or Local Public Health Clinic/Center
  • Bakersville, NC
  • NPI 1295864452

  O20130703000611

  Same enrollment
• Toe River Health District

  • Case Management Agency
  • Bakersville, NC
  • NPI 1952431520

  O20130703000611

  Same enrollment

Locations

Practitioners 3

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

• David Franklin Craig, M.D.

  • Family Medicine Physician
  • Burnsville, NC
  • NPI 1780624072
  NPD
• Evergreen Emmejune Haverkamp, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
  • NPI 1700495553
  NPD
• Samantha S McIntosh, FNP

  • Family Nurse Practitioner
  • Bakersville, NC
  • NPI 1639299886
  NPD

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1902855786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MEDICAL CAMPUS DR.",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "28714",
            "telephone_number": "828-682-6118",
            "fax_number": "828-682-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MEDICAL CAMPUS DR.",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "28714",
            "telephone_number": "828-682-6118",
            "fax_number": "828-682-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANCEY COUNTY PRIMARY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "KINNANE",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "INTERIM HEALTH DIRECTOR",
        "authorized_official_telephone_number": "828-765-9081",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343828A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343828C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404300",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404484",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Toe River Health District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yancey Co Health Department
• Yancey Co. DSS
• Yancey Community Medical Services, Inc.
• Yancey Community Medical Services, Inc.
• Yancey County Committee on Aging, Inc.
• Yancey County Schools
• Yancey County Transportation
• Yancey Home Care Inc
• Yancey House, LLC
• Yancey Residential Services, Inc.

• All providers in Burnsville, NC
• Rural Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.