Organization Active NPI

Mountain Convenient Care

  • Family Medicine Physician
  • Franklin, NC
National Provider Identifier
1922828466
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOUNTAIN CONVENIENT CARE
Practice address
106 Frogtown Lane
Frogtown LN
Franklin, NC 28734
Phone
(828) 482-5494
NPI assigned
Oct 10, 2024
Last updated
May 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Jodi F Balderrama, FNPNPI 1407490600
Title
Owner
Phone
(828) 369-0359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

106 Frogtown Lane
Frogtown LN
Franklin, NC 28734

Mailing address

106 Frogtown Lane
Franklin, NC 28734
Phone (828) 369-0359

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250513001104 NC Part B Supplier - Clinic/Group Practice 1254859366 Receives reassigned benefits from 1 practitioner
Practice locations: Franklin, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2316248Mountain Convenient Care106 Frogtown Lane, Franklin, NC 28734Certificate of waiverDec 30, 2026

National Provider Directory

National Provider Directory

Locations

153 Heritage Hollow Dr
Franklin, NC 28734

Practitioners & affiliated clinicians

Practitioners 2

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": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1922828466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FROGTOWN LANE",
            "city": "FRANKLIN",
            "state": "NC",
            "postal_code": "28734",
            "telephone_number": "828-369-0359",
            "fax_number": "877-673-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FROGTOWN LANE",
            "address_2": "FROGTOWN LN",
            "city": "FRANKLIN",
            "state": "NC",
            "postal_code": "28734",
            "telephone_number": "828-482-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN CONVENIENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2025-05-06",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "BALDERRAMA",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-369-0359",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.