NPIMap

Organization Active NPI

Henderson County Hospital Corporation

  • Federally Qualified Health Center (FQHC)
  • Hendersonville, NC
National Provider Identifier
1952030652
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HENDERSON COUNTY HOSPITAL CORPORATION
Practice address
611-B Fifth Avenue West
Hendersonville, NC 28739
Phone
(828) 698-3301
Fax
(828) 698-7133
NPI assigned
Jun 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Mr. Michael Lynn Sunday Jr.
Title
VP, Chief Financial Officer
Phone
(828) 696-1175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

611-B Fifth Avenue West
Hendersonville, NC 28739

Mailing address

5221 Paramount Pkwy Ste 440
Morrisville, NC 27560-5491
Phone (984) 974-1190

Other names 1

  • Pardee BlueMD-611B Fifth Avenue West Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230403000887 NC Part A Provider - Federally Qualified Health Center (FQHC) 8123938115 Practice locations: Hendersonville, NC
O20230710003578 NC Part B Supplier - Clinic/Group Practice 8123938115 Receives reassigned benefits from 6 practitioners
Practice locations: Hendersonville, NC

Federally qualified health center certification: CCN 861123

Legal name
HENDERSON COUNTY HOSPITAL CORPORATION
Doing business as
PARDEE BLUEMD-611 B FIFTH AVE WEST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 3, 2023
Last certification
Apr 3, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1998 in NC
Enrollment address
611 5TH Ave W
Ste B
Hendersonville, NC 28739-4296

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

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
34D2285058Pardee Bluemd611 Fifth Avenue West, Hendersonville, NC 28739Certificate of waiverJul 4, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrea Vivian Bolanos Padilla Individual Corporate DirectorBoard of Director Nov 1, 2021
Erik a Emaus Individual Corporate DirectorBoard Member Jul 1, 2025
John Gould Individual Corporate DirectorBoard of Director Nov 1, 2021
Hyatt James Chandler Individual Corporate DirectorBoard of Director Nov 1, 2021
Richard W Hudspeth Individual Corporate DirectorBoard of Director Oct 20, 2022
Marilyn Allison Gordon Individual Corporate DirectorBoard of Director Oct 1, 2022
James Stevens Brissie Individual Corporate DirectorBoard of Director Nov 1, 2022
County of Henderson Organization, Hendersonville, NC Operational/Managerial Control Feb 10, 2023 100%
University of North Carolina Health Care System Organization, Morrisville, NC Corporation Operational/Managerial Control Feb 10, 2023 100%
Hubbard Thomas Thompson Individual Corporate DirectorBoard of Director Nov 1, 2021
Suzanne Johnna Reed Individual Corporate OfficerChief Executive Officer Nov 1, 2021
Laura Ward Individual W-2 Managing EmployeeDirector of Practice Operations Nov 1, 2021
Maurean Yates Burritt Adams Individual Corporate DirectorBoard Member Jul 1, 2025
Maurice Lamont Jones Individual Corporate DirectorBoard Member Jul 1, 2025
Michael Lynn Sunday Individual Corporate OfficerChief Financial Officer, Vice Pres Nov 1, 2021
Orr Tamela Albrecht Individual Corporate DirectorBoard of Director Mar 1, 2024
Gregory S McCarty Individual Corporate OfficerChief Medical Officer Jan 1, 2022
Carla Jayne Icenhower Individual Corporate DirectorBoard Member Jul 1, 2025

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pardee Home CareFlat Rock, NC, CCN 347028 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 24, 1998
Apr 24, 1998

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 44

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 44

Practitioners & affiliated clinicians

Practitioners 6

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": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1952030652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 440",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605491",
            "telephone_number": "984-974-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611-B FIFTH AVENUE WEST",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "28739",
            "telephone_number": "828-698-3301",
            "fax_number": "828-698-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON COUNTY HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "SUNDAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "VP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "828-696-1175",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pardee BlueMD-611B Fifth Avenue West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pardee BlueMD-611B Fifth Avenue West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.