CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC – NPI #1215098132
Emergency Medicine

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC is a provider located in LINVILLE, NC. NPPES has assigned the NPI number 1215098132 to CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC on December 13, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207PE0004X from the Health Care Provider Taxonomy code set, which is classified as Emergency Medicine, specializing in Emergency Medical Services

The NPI profile was last updated on Jan 15, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC below.

NPI Profile for
CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC

NPI Number
1215098132
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC
Primary location
434 HOSPITAL DRIVE
LINVILLE, NC 28646-0787
Phone: (828) 262-9154 Fax: (828) 262-9159
Mailing address
PO BOX 787
LINVILLE, NC 28646-0787
Phone: (828) 262-9154 Fax: (828) 262-9159
Organization Subpart
No
Authorized Official
MARY LONG
SR VP MEDICAL STAFF SERVICES
Phone: (828) 262-4133
Updated
Certification Date
Jan 15, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBLUE CROSS OF NC019MG
otherBLUECARENC0094980
medicaidNC8907744
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207PE0004X
- Emergency Medicine / Emergency Medical Services (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.1068.1
Content Type
Affiliation
Y
Endpoint Location
2720 DUNDEE RD # 302,
NORTHBROOK, IL 77025-1669