Charles a. Cannon Jr. Memorial Hospital
Organization Active NPI Medical Specialty Clinic/Center · Linville, NC
NPI 1912002189 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1912002189
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Specialty Clinic/Center 261QM2500X
- License
- H0037 (NC)
- Legal business name
- CHARLES A. CANNON JR. MEMORIAL HOSPITAL
- Practice address
- 436 Hospital Dr, Sloop Medical Office Plaza
Suite 210
Linville, NC 28646 - Phone
- (828) 737-7865
- Fax
- (828) 737-7867
- NPI assigned
- Sep 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Teresa Elaine Barrier
- Title
- Director Patient Fin. Services
- Phone
- (828) 737-7011
Other NPIs on the same Medicare enrollment 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000998 | NC | Part B Supplier - Clinic/Group Practice | 3274426952 |
Receives reassigned benefits from 29 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Linville, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | H0037 | NC | Yes |
Addresses
Primary practice location
436 Hospital Dr, Sloop Medical Office Plaza
Suite 210
Linville, NC 28646
Mailing address
PO Box 459
Linville, NC 28646-0459
Phone (828) 737-7865
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132NK | Other | NC | BC OF NC GRP PROV NUMBER |
| 5902144 | Medicaid | NC | |
| 89132NK | Medicaid | NC | |
| 018G2 | Other | NC | BC OF NC GRP PROV NUMBER |
Other names
- Cannon Medical Associates
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Linville, NC
- Charles a Cannon Jr Memorial Hospital Inc
- Charles a Cannon Jr Memorial Hospital Inc
- Charles a Cannon Jr Memorial Hospital Inc.
- Charles a Cannon Jr Memorial Hospital Inc.
- Charles a Cannon Jr Memorial Hospital, Inc.
- Charles a. Cannon, Jr. Memorial Hospital, Inc
- Charles a. Cannon, Jr. Memorial Hospital, Inc
- Charles a. Cannon, Jr. Memorial Hospital, Inc
- Charles a. Cannon, Jr. Memorial Hospital, Inc.
- Charles a. Cannon, Jr. Memorial Hospital, Inc.
All providers in Linville, NC · Medical Specialty Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.