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NPI Code Detail

MEDICARE: FOOTHILLS FAMILY HEALTH CARE

MEDICARE: FOOTHILLS FAMILY HEALTH CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner700004NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1013K4OTHERNCBCBS PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629156963
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOOTHILLS FAMILY HEALTH CARE
Provider Business Mailing Address
First Line : 249 OAK ST
Second Line :
City : FOREST CITY
State : NC
Zip : 28043-3585
Country : US
Telephone Number : 828-245-3158
Fax Number : 828-247-6484
Provider Business Practice Location Address
First Line : 249 OAK ST
Second Line :
City : FOREST CITY
State : NC
Zip : 28043-3585
Country : US
Telephone Number : 828-245-3158
Fax Number : 828-247-6484
Authorized Official
Title or Position : OWNER
Name : MRS. DONNA FERRELL GILL
Credential : FNP-C
Telephone Number : 828-245-3158
Provider Enumeration Date : 11/02/2006
Last Update Date : 08/22/2020

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Practice Location Address:
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1912948084 — MR. MICHAEL BRANDON WATERS LPT
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1255585899 — CLEVELAND HEALTH VENTURES
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1417399403 — CAROLINAS PHYSICIANS NETWORK, INC.
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1598209553 — SHERI HYDER COUCH
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1710404421 — DONNA LYNN HEWITT FNP-C
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Directions to “FOOTHILLS FAMILY HEALTH CARE ” Practice Location

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