Charles a Cannon Jr Memorial Hospital Inc
Organization Active NPI Pulmonary Disease Physician · Linville, NC
NPI 1952976003 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1952976003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC
- Practice address
- 434 Hospital Dr
Linville, NC 28646 - Phone
- (828) 262-4133
- Fax
- (828) 262-4103
- NPI assigned
- May 21, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- CHARLES A CANNON JR MEMORIAL HOSPITAL INC.
Authorized official
- Name
- Mary Etta Long
- Title
- SVP Medical Staff Relations
- Phone
- (828) 262-4133
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 13
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140813002123 | NC | Part B Supplier - Clinic/Group Practice | 3274426952 |
Receives reassigned benefits from 61 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Linville, NC |
National Provider Directory
- Tax ID family
- Sloop Cap-Avery Home Care Services
- Part of
- Sloop Cap-Avery Home Care Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
434 Hospital Dr
Linville, NC 28646
Mailing address
434 Hospital Dr
Linville, NC 28646
Phone (828) 262-4133
Other names
- Pulmonology Inpatient
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
- Charles a Cannon Jr Memorial Hospital
- Charles a Cannon Jr Memorial Hospital
- 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
- Charles a. Cannon, Jr. Memorial Hospital, Inc
All providers in Linville, NC · Pulmonary Disease Physician 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.