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CAITLIN M. DOWNING MD
NPI 1609221407
Family Medicine in Jefferson, NC

Active since April 29, 2016PECOS EnrolledAccepts Medicare Assignment
327 E. MAIN STREET, JEFFERSON, NC 28640(336) 489-4400(336) 489-4500 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 23, 2024, Dec 6, 2022, Apr 1, 2021 and 1 more (4 updates tracked since 2016).

About Caitlin M. Downing Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAITLIN M. DOWNING MD (NPI 1609221407) is an individual family medicine provider in Jefferson, North Carolina, licensed in North Carolina (218241) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Ashe Memorial Hospital, and maintains a secondary practice location in Jefferson.

NPPES Registry Identity

NPI1609221407
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCAITLIN M. DOWNINGCredential: MD
Location Address327 E. MAIN STREETJefferson, NC 28640
Mailing Address327 E. Main StreetJefferson, NC 28640 · (336) 489-4400 · Fax (336) 489-4500
Phone(336) 489-4400
Fax(336) 489-4500
Sole ProprietorNo
Medical School CMSUniversity Of Connecticut School Of MedicineGraduated 2016
Enumeration DateApril 29, 2016
Last NPPES UpdateJanuary 22, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2025
✔ NPI 1609221407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 218241
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
327 E. MAIN STREET, Jefferson, NC 28640
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Other Names 1

Former Name (1)Caitlin M. Sullivan Md

Secondary Practice Location 1

Location 1200 Hospital AveJefferson, NC 28640-9244 · Phone (338) 846-7101

Other Identifiers 1

OtherNN9861DNC · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Caitlin M. Downing Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709170483
PECOS Enrollment IDI20191216002172
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Caitlin Downing reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ashe Memorial Hospital Inc
0.7 mi
Hospitalist
200 HOSPITAL AVE
Jefferson, NC 28640
  • Reassigned Medicare billing, North Carolina enrollment
  • 15 clinicians in this Medicare group
NPI 1861592271 (336) 846-7101
Jefferson Emergency Services, PLLC
0.8 mi
Emergency Medicine
200 HOSPITAL AVE
Jefferson, NC 28640
  • Reassigned Medicare billing, North Carolina enrollment
  • 61 clinicians in this Medicare group
NPI 1720495336 (336) 846-0820
Henderson County Hospital Corporation
89 mi
Federally Qualified Health Center (FQHC)
2775 HENDERSONVILLE RD
Arden, NC 28704
  • Reassigned Medicare billing, North Carolina enrollment
  • 401 clinicians in this Medicare group
NPI 1619606316 (828) 694-8900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
82 services79 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
58 services57 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
37 services36 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ashe Memorial Hospital

Critical Access Hospitals · Jefferson, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number341325
Location200 Hospital AveJefferson, NC 28640 · Ashe County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28640 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier21 claims21 services$19.22 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier23 claims23 services$113.01 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Caitlin Downing's NPI number?

The NPI number for Caitlin Downing is 1609221407. It was assigned to this individual provider in the NPPES registry on April 29, 2016. The provider is also known as Caitlin M. Sullivan MD.

Where is Caitlin Downing located?

Caitlin Downing practices at 327 E. Main Street, Jefferson, NC 28640. The listed phone number is (336) 489-4400.

What is Caitlin Downing's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Caitlin Downing enrolled in Medicare?

Yes. Caitlin Downing is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Caitlin Downing's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Caitlin Downing reassigns Medicare benefits to 3 organizations: Ashe Memorial Hospital Inc (Jefferson, NC), Jefferson Emergency Services, PLLC (Jefferson, NC) and Henderson County Hospital Corporation (Arden, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Caitlin Downing's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Caitlin Downing accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 1 other insurer list Caitlin Downing as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Caitlin Downing affiliated with any hospitals?

According to CMS data, Caitlin Downing is affiliated with Ashe Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Caitlin Downing was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.