CHARLES A CANNON JR MEMORIAL HOSPITAL, INC. (NPI# 1073073953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073073953 |
| Entity Type | Organization |
| Organization Name | CHARLES A CANNON JR MEMORIAL HOSPITAL, INC. |
| Practice Address |
150 Park Ave Banner Elk NC 28604-6604 |
| Mailing Address |
155 Furman Rd Ste 202 Boone NC 28607-5049 |
| Practice Telephone | 8288985178 |
| Practice Fax Number | 8282624103 |
| Mailing Telephone | 8282631211 |
| Mailing Fax Number | 8282624103 |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |
| Authorized Official Name | MARY ETTA LONG (SR. VP MEDICAL STAFF RELATIONS) |
| Authorized Official Telephone | 8282624133 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Elk River Center for Primary Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376611574 | Charles A Cannon Jr Memorial Hospital, Inc. | Medicare Defined Swing Bed Unit | 434 Hospital Drive, Linville, NC 28646-0787 | 2006-12-04 |
| Street Address |
150 PARK AVE |
| City | BANNER ELK |
| State | NC |
| Zip Code | 28604-6604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093700338 | Elk River Medical Associates, Pa | Clinic/Center | 150 Park Ave, Banner Elk, NC 28604-6604 | 2005-09-13 |
| 1487891933 | Appalachian Regional Medical Associates | Internal Medicine | 150 Park Ave, Banner Elk, NC 28604-6604 | 2009-01-20 |
| 1053306092 | David Paul Kimmel | Internal Medicine | 150 Park Ave, Banner Elk, NC 28604-6604 | 2005-09-15 |
| 1699760959 | Alfred Douglas Earwood | Family Medicine | 150 Park Ave, Banner Elk, NC 28604-6604 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184194755 | William H Burrow Dds Pllc Dba High Country Dental Associates | Clinic/Center | 2043 Tynecastle Highway, Banner Elk, NC 28604 | 2018-11-27 |
| 1699268953 | Barium Springs Home for Children | Community/Behavioral Health | 158 Grandfather Home Drive Bldg 2, Banner Elk, NC 28604 | 2018-06-12 |
| 1578973996 | Grandfather Home for Children, Inc. | Community Based Residential Treatment Facility, Mental Illness | 158 Grandfather Home Drive, Banner Elk, NC 28604 | 2014-05-07 |
| 1134417314 | Grandfather Home for Children, Inc. | Community Based Residential Treatment Facility, Mental Illness | 233 Grandfather Home Dr., Banner Elk, NC 28604 | 2011-07-21 |
| 1841598745 | Ivan Smith | Pharmacist | 4059 Nc Hwy 105, Rite Aid Pharmacy, Sugar Mountain, NC 28604 | 2011-03-02 |
| 1043515679 | Grandfather Home for Children, Incorporated | Community/Behavioral Health | 64 Grandfather Home Drive, Banner Elk, NC 28604 | 2011-01-12 |
| 1710133012 | Stephanie Knowles | Social Worker | 158 Grandfather Home for Children Way, Hickory Nut Gap Road, Banner Elk, NC 28604 | 2008-08-18 |
| 1235313909 | Dennis Robert Blair | Respiratory Therapist, Registered | 335 Leslie Ln, Banner Elk, NC 28604 | 2007-12-18 |
| 1780867291 | Robert Jones | Spec/Tech, Cardiovascular | 28 Wildcat Creek Lane, Banner Elk, NC 28604 | 2007-12-07 |
| 1730308172 | Erling L Fredrickson | Social Worker | 158 Grandfather Home Way, Hickory Nut Gap Rd., Banner Elk, NC 28604 | 2007-04-24 |
| Find all providers in zip 28604 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689209553 | Murphy Medical Center Inc | Clinic/Center | 125 Medical Park Ln Ste H, Murphy, NC 28906-6921 | 2020-03-11 |
| 1528623725 | Cynthia Mcarthur-kearney | Clinic/Center | 531 Hillsboro St, Fayetteville, NC 28301-4634 | 2019-05-03 |
| 1528559671 | Bladen Healthcare LLC | Clinic/Center | 273 White Lake Dr, White Lake, NC 28337 | 2018-05-24 |
| 1043759335 | Bladen Healthcare LLC | Clinic/Center | 88 E Green St., Clarkton, NC 28433-5002 | 2017-02-20 |
| 1114269677 | Bladen Healthcare LLC | Clinic/Center | 107e Dunham St, Elizabethtown, NC 28337-9037 | 2013-03-22 |
| 1699062802 | Cah Acquisition Company 1 LLC | Clinic/Center | 9500 Nc Highway 94 North, Creswell, NC 27928-8808 | 2011-07-08 |
| 1912294687 | Pioneer Health Services of Stokes County, Inc. | Clinic/Center | 1020 Hospice Drive, Danbury, NC 27016-0000 | 2011-07-01 |
| 1578858247 | Warren Community Health Clinic Inc. | Clinic/Center | 546 W Ridgeway St, Warrenton, NC 27589-1716 | 2011-06-10 |
| 1427282045 | Southeastern Regional Physician Services | Clinic/Center | 2002 N Cedar St Ste B, Lumberton, NC 28358-3926 | 2009-05-11 |
| 1578702189 | Appalachian Healthcare, Inc. | Clinic/Center | 9330 Highway 194, Lansing, NC 28643-0184 | 2009-02-05 |
| Find all providers with the same taxonomy | ||||
| City | BANNER ELK |
| Zip Code | 28604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.