| Watauga Medical Center | |
|
336 Deerfield Rd Boone NC 28607-5008 | |
| (828) 262-9100 | |
| (828) 262-4157 |
| Full Name | Watauga Medical Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 336 Deerfield Rd, Boone, North Carolina |
| Authorized Official Name and Position | Mary Etta Long (SR VP MEDICAL STAFF SERVICES) |
| Authorized Official Contact | 8282624133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Watauga Medical Center 155 Furman Rd Suite 101 Boone NC 28607-5049 Ph: (828) 262-9100 | Watauga Medical Center 336 Deerfield Rd Boone NC 28607-5008 Ph: (828) 262-9100 |
| NPI Number | 1407921802 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 10/14/2013 |
| Medicare PECOS PAC ID | 2668377474 |
|---|---|
| Medicare Enrollment ID | O20060220000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407921802 | NPI | - | NPPES |
| 8907630 | Medicaid | NC | |
| 07630 | Other | NC | BCBS PSY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Alycia Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790762078 PECOS PAC ID: 6800783747 Enrollment ID: I20040303001266 |
| Provider Name | Marianne L Buchanan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467532564 PECOS PAC ID: 8921050410 Enrollment ID: I20050212000024 |
| Provider Name | Eugene Leonard Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134148745 PECOS PAC ID: 4284739988 Enrollment ID: I20070424000596 |
| Provider Name | Rebecca L Moretz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689701559 PECOS PAC ID: 5799884516 Enrollment ID: I20070620000174 |
| Provider Name | Colleen Carol Frye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629109152 PECOS PAC ID: 2961502885 Enrollment ID: I20070706000530 |
| Provider Name | Jennifer F Womble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346374329 PECOS PAC ID: 8820174881 Enrollment ID: I20080401000151 |
| Provider Name | Ella T Markland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043395965 PECOS PAC ID: 6507939832 Enrollment ID: I20080721000297 |
| Provider Name | Grace Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659460814 PECOS PAC ID: 4183760945 Enrollment ID: I20091007000779 |
| Provider Name | Ivy De Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871726679 PECOS PAC ID: 7416094982 Enrollment ID: I20091102000595 |
| Provider Name | Bradley Tanner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447348131 PECOS PAC ID: 8325178650 Enrollment ID: I20100614000466 |
| Provider Name | Daniel F Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609011600 PECOS PAC ID: 8426110651 Enrollment ID: I20110214000546 |
| Provider Name | Jenny Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346299187 PECOS PAC ID: 7416861513 Enrollment ID: I20111024000680 |
| Provider Name | Steven Edward Sand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871737916 PECOS PAC ID: 7012146434 Enrollment ID: I20140206000340 |
| Provider Name | Brian Sealy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548698434 PECOS PAC ID: 4688892888 Enrollment ID: I20140829002305 |
| Provider Name | Carrie A Richardson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497010011 PECOS PAC ID: 7719296797 Enrollment ID: I20151013001359 |
| Provider Name | Katherine K Elder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316334709 PECOS PAC ID: 9133420045 Enrollment ID: I20151218000934 |
| Provider Name | Robert S Broce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235595489 PECOS PAC ID: 6204133911 Enrollment ID: I20160323002424 |
| Provider Name | Jessica L Storer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619359338 PECOS PAC ID: 5294035655 Enrollment ID: I20161114000789 |
| Provider Name | Matthew Thomas Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861762528 PECOS PAC ID: 5799065660 Enrollment ID: I20161212000519 |
| Provider Name | Jesse B Creech |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588947501 PECOS PAC ID: 6507146404 Enrollment ID: I20161212001462 |
| Provider Name | Maria Ela Aguilar-donis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811285901 PECOS PAC ID: 3274822150 Enrollment ID: I20170530002558 |
| Provider Name | Luna Sanchez Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942584776 PECOS PAC ID: 4183995418 Enrollment ID: I20170804002667 |
| Provider Name | Michael C Stevens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538175484 PECOS PAC ID: 7315038601 Enrollment ID: I20180306001456 |
| Provider Name | Ronald R Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154701274 PECOS PAC ID: 5294098976 Enrollment ID: I20180411000097 |
| Provider Name | Shan A Bassion |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841780616 PECOS PAC ID: 0446506083 Enrollment ID: I20180711003453 |
| Provider Name | Nickolas Hamilton Culpepper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184069544 PECOS PAC ID: 7012280514 Enrollment ID: I20180910000424 |
| Provider Name | Eric M Bishop |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710365267 PECOS PAC ID: 3375851009 Enrollment ID: I20200530000159 |
| Provider Name | Melanie A Bradford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679149223 PECOS PAC ID: 6406248293 Enrollment ID: I20220128001702 |
| Provider Name | Melissa K Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891271888 PECOS PAC ID: 1658754098 Enrollment ID: I20220817001423 |
| Provider Name | Kourtnei M Robinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437687654 PECOS PAC ID: 4880082601 Enrollment ID: I20220819001023 |
| Provider Name | Robert J Bartucci |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912054990 PECOS PAC ID: 5092717553 Enrollment ID: I20230130002552 |
| Provider Name | Paige L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477115517 PECOS PAC ID: 0042683773 Enrollment ID: I20230228002556 |
| Provider Name | Taylor Y Quattlebaum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346709623 PECOS PAC ID: 9931441367 Enrollment ID: I20231004002125 |
| Provider Name | Benjamin Seth Ramsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255998027 PECOS PAC ID: 9638501430 Enrollment ID: I20231009001590 |
| Provider Name | Melanie D Childers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740544790 PECOS PAC ID: 6406207539 Enrollment ID: I20240112001933 |
| Provider Name | Rachel A Feldman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861841116 PECOS PAC ID: 4486091592 Enrollment ID: I20240326000184 |
| Provider Name | Gregory M Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518711910 PECOS PAC ID: 1951743848 Enrollment ID: I20240523001429 |
Don Campany Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 Northridge Dr, Boone, NC 28607 Phone: 828-264-4048 | |
Perseverant Hope Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Marion Cornett Rd, Boone, NC 28607 Phone: 716-359-6031 | |
Broken Angel Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2208 Us Highway 421 N, Boone, NC 28607 Phone: 724-968-2435 | |
Mentor Behavioral Healthcare, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 249 Wilson Dr Ste 5, Boone, NC 28607 Phone: 828-278-9498 Fax: 877-211-7323 | |
Icenhour Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 184 N Water St Ste 10, Boone, NC 28607 Phone: 828-719-8779 | |
True North Counseling Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 838 State Farm Rd, Suite 1, Boone, NC 28607 Phone: 828-386-6000 | |
New River Behavioral Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 895 State Farm Rd, Suite 508, Boone, NC 28607 Phone: 828-264-9007 Fax: 828-262-5687 |