MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC
Complete NPI Record 1366912586
Internal Medicine in Arden, NC
Active since November 30, 2018
Complete NPI Dataset
This page contains the complete raw NPPES record for Mission Health Community Multispecialty Providers, Llc (NPI 1366912586), an internal medicine organization in Arden, NC. All 34 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1366912586 Field 1/34
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/34
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/34
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC Field 4/34
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: 2000 HEALTH PARK DR Field 5/34
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: BRENTWOOD Field 6/34
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TN Field 7/34
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 370274692 Field 8/34
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/34
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6153737406 Field 10/34
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 8663661426 Field 11/34
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 310 LONG SHOALS RD STE 110 Field 12/34
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: ARDEN Field 13/34
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NC Field 14/34
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 287048794 Field 15/34
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/34
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8282131740 Field 17/34
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: JOHNSON Field 20/34
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: TEDRICK Field 21/34
- The first name of the authorized official.
- Authorized Official Title or Position: GROUP VICE PRESIDENT Field 22/34
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6153723375 Field 23/34
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207R00000X Field 24/34
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 25/34
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 02CG9 Field 26/34
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 27/34
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: NC Field 28/34
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: BC/BS NC Field 29/34
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: Y Field 30/34
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Parent Organization LBN: MISSION HEALTH COMMUNITY MULTISPECIALTY PROVIDERS, LLC Field 31/34
- The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
- Parent Organization TIN: Not available Field 32/34
- The Taxpayer Identification Number (TIN) of the parent organization, provided when the provider is a subpart of a larger entity. This field identifies the federal tax ID used by the parent organization for official and billing purposes.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 33/34
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 45
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
509 Biltmore Ave
Location 1/45Asheville, NC 28801-4601 · Phone (828) 213-1740
31 E Medical Ct Ste 2
Location 2/45Marion, NC 28752-4969 · Phone (828) 213-1740
1388 Sand Hill Rd
Location 3/45Candler, NC 28715-8937 · Phone (828) 213-1740
159 Medical Park Dr Ste B
Location 4/45Brevard, NC 28712-4191 · Phone (828) 213-1740
310 Long Shoals Rd Ste 320
Location 5/45Arden, NC 28704-8794 · Phone (828) 213-1740
1 Hospital Dr Ste 3400
Location 6/45Asheville, NC 28801-4550 · Phone (828) 213-1740
1 Hospital Dr Ste 4100
Location 7/45Asheville, NC 28801-4550 · Phone (828) 213-1740
100 Ridgefield Ct
Location 8/45Asheville, NC 28806-2270 · Phone (828) 213-1740
21 Hospital Dr Fl 4
Location 9/45Asheville, NC 28801-4550 · Phone (828) 213-1740
21 Hospital Dr Fl 2
Location 10/45Asheville, NC 28801-4550 · Phone (828) 213-1740
189 Hospital Dr
Location 11/45Spruce Pine, NC 28777-3035 · Phone (828) 213-1740
609 Asheville Hwy
Location 12/45Sylva, NC 28779-2747 · Phone (828) 213-1740
430 Rankin Dr
Location 13/45Marion, NC 28752-6568 · Phone (828) 213-1740
1633 Sugar Hill Rd
Location 14/45Marion, NC 28752-5239 · Phone (828) 213-1740
472 Rankin Dr
Location 15/45Marion, NC 28752-6568 · Phone (828) 213-1740
149 W Parker Rd
Location 16/45Morganton, NC 28655-4673 · Phone (828) 213-1740
128 Dr Henry Norris Dr
Location 17/45Rutherfordton, NC 28139-3165 · Phone (828) 213-1740
187 Medical Park Dr
Location 18/45Brevard, NC 28712-4189 · Phone (828) 213-1740
260 Hospital Dr
Location 19/45Brevard, NC 28712-3378 · Phone (828) 213-1740
316 Chestnut St Ste 2
Location 20/45Brevard, NC 28712-3897 · Phone (828) 213-1740
377 Gallimore Rd
Location 21/45Brevard, NC 28712-8874 · Phone (828) 213-1740
89 Hospital Dr Ste A
Location 22/45Brevard, NC 28712-4838 · Phone (828) 213-1740
89 Hospital Dr Ste C
Location 23/45Brevard, NC 28712-4838 · Phone (828) 213-1740
800 Medical Campus Dr
Location 24/45Burnsville, NC 28714-9010 · Phone (828) 213-1740
209 Hospital Dr
Location 25/45Highlands, NC 28741-7623 · Phone (828) 213-1740
209 Hospital Dr Ste 104
Location 26/45Highlands, NC 28741-7622 · Phone (828) 213-1740
209 Hospital Dr Ste 303
Location 27/45Highlands, NC 28741-7616 · Phone (828) 213-1740
16825 Rosman Hwy
Location 28/45Lake Toxaway, NC 28747-9593 · Phone (828) 213-1740
57 White Owl Ln
Location 29/45Cashiers, NC 28717-4514 · Phone (828) 213-1740
120 Riverview St
Location 30/45Franklin, NC 28734-2612 · Phone (828) 213-1740
5 Vanderbilt Park Dr
Location 31/45Asheville, NC 28803-1700 · Phone (828) 213-1740
711 New Leicester Hwy
Location 32/45Asheville, NC 28806-1048 · Phone (828) 213-1740
428 Biltmore Ave Ste U2722nd
Location 33/45Asheville, NC 28801-4502 · Phone (828) 213-1740
428 Biltmore Ave Fl 4
Location 34/45Asheville, NC 28801-4502 · Phone (828) 213-1740
428 Biltmore Ave
Location 35/45Asheville, NC 28801-4502 · Phone (828) 213-1740
41 Oakland Rd Ste 100
Location 36/45Asheville, NC 28801-4821 · Phone (828) 213-1740
30 Choctaw St Ste A
Location 37/45Asheville, NC 28801-4514 · Phone (828) 213-1740
310 Long Shoals Rd Ste 310
Location 38/45Arden, NC 28704-8794 · Phone (828) 213-1740
2695 Hendersonville Rd Ste 204
Location 39/45Arden, NC 28704-8576 · Phone (828) 213-1740
190 Hospital Dr
Location 40/45Highlands, NC 28741-7600 · Phone (828) 213-1740
691 Blythe Street Ct
Location 41/45Hendersonville, NC 28739-4095 · Phone (828) 213-1740
834 Depot St Ste 210
Location 42/45Franklin, NC 28734-0176 · Phone (828) 213-1740
55 Medical Park Dr Ste 114
Location 43/45Franklin, NC 28734-2653 · Phone (828) 213-1740
190 Riverview St
Location 44/45Franklin, NC 28734-2612 · Phone (828) 213-1740
125 Hospital Dr
Location 45/45Spruce Pine, NC 28777-3035 · Phone (828) 213-1740
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
02CG9 Other
Identifier 1/1State: NC · Issuer: Bc/bs Nc
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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