Anson Regional Medical Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ANSON REGIONAL MEDICAL SERVICES, INC

Practice address

203 Salisbury St
Wadesboro, NC 28170-2155

Phone

(704) 694-6700

Fax

(704) 695-1227

NPI assigned

Feb 20, 2007

Last updated

Jul 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Gwendolyn Reed, MPA,RHIT

Title

Chief Executive Officer

Phone

(704) 694-6700

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992840003. Details of each certification follow.

• CCN 341861 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 341861

Legal name

ANSON REGIONAL MEDICAL SERVICES, INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 12, 2001

Last certification

Apr 12, 2001

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jan 31, 1992 in NC

Enrollment address

203 Salisbury St
Wadesboro, NC 28170-2155

Other NPIs with the same Medicare PAC ID 1

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

• Anson Regional Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Monroe, NC
  • NPI 1649540105

  1052389103

  Same PAC ID

All disclosed owners & managing parties 5

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

Practitioners 1

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.

• Cynthia Ann King

  • Nurse Practitioner
  • Monroe, NC
  • NPI 1285144865
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1992840003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "address_2": "203 SALISBURY STREET",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281700192",
            "telephone_number": "704-694-6700",
            "fax_number": "704-694-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SALISBURY ST",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702155",
            "telephone_number": "704-694-6700",
            "fax_number": "704-695-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANSON REGIONAL MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-694-6700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPA,RHIT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344553",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Federally Qualified Health Center (FQHC) in Wadesboro, NC
• Providers in Wadesboro, NC by specialty
• Federally Qualified Health Center (FQHC) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.