| Cannon Inpatient Behavioral Health | |
|
434 Hospital Drive Linville NC 28646-0787 | |
| (828) 737-7000 | |
| (828) 737-7709 |
| Full Name | Cannon Inpatient Behavioral Health |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 434 Hospital Drive, Linville, North Carolina |
| Authorized Official Name and Position | Mary Etta Long (SR VP MEDICAL STAFF RELATIONS) |
| Authorized Official Contact | 8282624133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cannon Inpatient Behavioral Health 155 Furman Rd Ste 101 Boone NC 28607-5049 Ph: (828) 262-9100 | Cannon Inpatient Behavioral Health 434 Hospital Drive Linville NC 28646-0787 Ph: (828) 737-7000 |
| NPI Number | 1407006968 |
|---|---|
| Provider Enumeration Date | 09/22/2008 |
| Last Update Date | 04/15/2019 |
| Medicare PECOS PAC ID | 3274426952 |
|---|---|
| Medicare Enrollment ID | O20040205000998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407006968 | NPI | - | NPPES |
| 021YE | Other | NC | BCBSNC |
| 3401323S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 273R00000X | Psychiatric Unit | H0037 (North Carolina) | Primary |
| 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 | 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 | Jo A Orr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417072661 PECOS PAC ID: 3476628652 Enrollment ID: I20080822000325 |
| Provider Name | Delinda Kay Woody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780864025 PECOS PAC ID: 3577624683 Enrollment ID: I20081208000643 |
| 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 | Daniel F Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609011600 PECOS PAC ID: 8426110651 Enrollment ID: I20110214000546 |
| 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 | David H Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437519501 PECOS PAC ID: 2961709878 Enrollment ID: I20160321000977 |
| 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 | 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 | Susan Schleith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760017826 PECOS PAC ID: 7113357773 Enrollment ID: I20200422001121 |
| Provider Name | Eric M Bishop |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710365267 PECOS PAC ID: 3375851009 Enrollment ID: I20200530000159 |
| 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 |
Arbh Providers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 432 Hospital Dr, Linville, NC 28646 Phone: 828-262-4133 Fax: 828-262-4103 | |
Cannon Op Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 434 Hospital Drive, Linville, NC 28646 Phone: 828-262-9154 Fax: 828-262-9159 | |
Arbh Triage Providers Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 432 Hospital Dr, Linville, NC 28646 Phone: 828-262-4133 Fax: 828-262-4103 |