CATAWBA VALLEY PRIMARY CARE, PLLC - NPI NUMBER 1720161805

Summary

Provider Name: CATAWBA VALLEY PRIMARY CARE, PLLC

NPI Number: 1720161805

Clasification: Family Medicine (207Q00000X)

Address:
2180 NORTHWEST BLVD
SUITE A
NEWTON, NC
ZIP 28658

Phone Number: (828) 464-7800



Detailed Information

CATAWBA VALLEY PRIMARY CARE, PLLC is a family physician in Newton, NC. The provider is 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. The assigned NPI number for this provider is 1720161805 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

2180 NORTHWEST BLVD
SUITE A
NEWTON, NC
ZIP 28658-724
Phone: (828) 464-7800
Fax: (828) 464-7825

The provider's authorized official is Raymond H Osterer .
The authorized official title is Owner and has the following contact phone number (828) 464-7800.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 12/10/2009.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207Q00000X Family Medicine Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 011RE OTHER NC BCBS GROUP #
2 2334750 MEDICARE ID-TYPE UNSPECIFIED NC GROUP #
3 89011RE MEDICAID NC
4 R77871 MEDICARE UPIN NC
5 F54531 MEDICARE UPIN

NPI Record

No. Field Name Field Value
1 NPI 1720161805
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name CATAWBA VALLEY PRIMARY CARE, PLLC
5 Provider First Line Business Practice Location Address 2180 NORTHWEST BLVD
6 Provider Second Line Business Practice Location Address SUITE A
7 Provider Business Practice Location Address City Name NEWTON
8 Provider Business Practice Location Address State Name NC
9 Provider Business Practice Location Address Postal Code 286583724
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 8284647800
12 Provider Business Practice Location Address Fax Number 8284647825
13 Provider Enumeration Date 10/23/2006
14 Last Update Date 12/10/2009
15 Authorized Official Last Name OSTERER
16 Authorized Official First Name RAYMOND
17 Authorized Official Middle Name H
18 Authorized Official Title or Position OWNER
19 Authorized Official Telephone Number 8284647800
20 Healthcare Provider Taxonomy Code 1 207Q00000X
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 011RE
23 Other Provider Identifier Type Code 1 01
24 Other Provider Identifier State 1 NC
25 Other Provider Identifier Issuer 1 BCBS GROUP #
26 Other Provider Identifier 2 2334750
27 Other Provider Identifier Type Code 2 04
28 Other Provider Identifier State 2 NC
29 Other Provider Identifier Issuer 2 GROUP #
30 Other Provider Identifier 3 89011RE
31 Other Provider Identifier Type Code 3 05
32 Other Provider Identifier State 3 NC
33 Other Provider Identifier 4 R77871
34 Other Provider Identifier Type Code 4 02
35 Other Provider Identifier State 4 NC
36 Other Provider Identifier 5 F54531
37 Other Provider Identifier Type Code 5 02
38 Is Organization Subpart N
39 Authorized Official Credential Text PHYSICIAN ASSISTANT
40 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.