EXTENDED CARE PHYSICIANS - MOUNTAIN, PA; NPI #1104823087

Contact Information

EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

90 SOUTHSIDE AVE
SUITE 300
ASHEVILLE, NC 28801-4160

Phone: 828-277-4810
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Geriatric Medicine	207RG0300X	11	Physician/Internal Medicine
Acute Care	363LA2100X	50	Nurse Practitioner
Adult Health	363LA2200X	50	Nurse Practitioner
Family	363LF0000X	50	Nurse Practitioner
Family Medicine	207Q00000X	08	Physician/Family Practice
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Geriatric Medicine	207QG0300X	08	Physician/Family Practice
Geriatric Psychiatry	2084P0805X	86	Physician/Neuropsychiatry
Gerontology	363LG0600X	50	Nurse Practitioner
Internal Medicine	207R00000X	11	Physician/Internal Medicine
Nurse Practitioner	363L00000X	50	Nurse Practitioner
Physician Assistant	363A00000X	97	Physician Assistant
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

NPI # 1104823087

LBN Legal business name EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

Authorized official ROBIN GLEESON-WARREN - (CREDENTIALING DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/07/2005

Last updated 04/16/2015 - About 11 years ago

Identifiers

NC	License #	200201376
NC	License #	86999
NC	Medicaid	89011JK
NC	Other	011JK	BCBSNC
NC	Other	56162	MEDCOST
NC	Other	CG9205	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

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NPI Profile & details for EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

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