Watauga Medical Center Inc
Organization Active NPI Hematology & Oncology Physician · Boone, NC
NPI 1972308930 · NPPES record last updated Feb 14, 2025
Key facts
- NPI
- 1972308930
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- WATAUGA MEDICAL CENTER INC
- Practice address
- 1200 State Farm Rd
Boone, NC 28607-4994 - Phone
- (828) 262-4332
- Fax
- (828) 265-5514
- NPI assigned
- Feb 14, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- WATAUGA MEDICAL CENTER INC
Authorized official
- Name
- Mary Etta Long
- Title
- SVP Medical Staff Relations
- Phone
- (828) 262-4133
Other NPIs with the same Medicare PAC ID 6
Practitioners 96
-
Marcia Ann Molnar, PA-C
-
Obiageli Uchenna Ogbata, M.D.
-
Saritha Ravella, M.D.
-
Lorraine Angel, CRNA
-
Angela Lunsford Baldwin, CRNA
-
Punit Baveja, MD
-
Xuguang Chen, MD
-
John Cuningham, MD
-
Ricardo De Leon, M.D.
-
Donna Patricia Denier, M.D.
-
Loralee H Eggers, PA-C
-
Rachel Feldman, LPCA
-
Peter Frye, CRNA
-
Daniel James Goble, M.D.
-
Michael R. Haake, M.D.
-
Amy Miller Jones, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250411001791 | NC | Part B Supplier - Clinic/Group Practice | 2668377474 |
Receives reassigned benefits from 6 practitioners Practice locations: Boone, NC |
National Provider Directory
- Part of
- Blue Ridge Physcial Therapy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
1200 State Farm Rd
Boone, NC 28607-4994
Mailing address
PO Box 2600
Boone, NC 28607-2600
Phone (828) 262-4133
Other names
- Medical Oncology
Other providers in Boone, NC
- Watauga Medical Center Inc
- Watauga Medical Center Inc
- Watauga Medical Center Inc
- Watauga Medical Center Inc
- Watauga Medical Center Inc
- Watauga Medical Center, Inc
- Watauga Medical Center, Inc.
- Watauga Medical Center, Inc.
- Watauga Medical Center, Inc.
- Watauga Medical Center, Inc.
All providers in Boone, NC · Hematology & Oncology 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 Feb 14, 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.