APPALACHIAN DISTRICT HEALTH DEPARTMENT — NPI 1134980931 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in SPARTA, NC)

CMS-1500 Box 24J / 33a • NPI

1134980931

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QP0905X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

450 N MAIN ST, SPARTA, NC, 28675-8608

✓ 9-Digit EDI 837 ZIP+4 (28675-8608)

Practice Phone & Referral Fax

(336) 246-9449

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1134980931 (APPALACHIAN DISTRICT HEALTH DEPARTMENT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1134980931` (NPI-2 Organization / Facility)
Provider / Legal Name	APPALACHIAN DISTRICT HEALTH DEPARTMENT
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QP0905X` (Clinic/Center, Public Health, State or Local)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	450 N MAIN ST, SPARTA, NC, 28675-8608
Practice Telephone / Fax	Tel: (336) 246-9449
Administrative Mailing Address	PO BOX 208, JEFFERSON, NC, 28640-0208
Enumeration & Last Sync	Enumerated: 2024-01-18 \| CMS Record Updated: 2024-06-13
Authorized Official	DANIELLE DOUGHERTY (Credentialer/Billing Coordinator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

450 N MAIN ST, SPARTA, NC, 28675-8608

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Plain-English Taxonomy & CMS Crosswalk (261QP0905X)

What Does Taxonomy Code 261QP0905X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QP0905X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (APPALACHIAN DISTRICT HEALTH DEPARTMENT)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`251K00000X` — Public Health or Welfare Plain English: Licensed & Credentialed Agencies — Public Health or Welfare	State: N/A \| License: `Verified` \| Primary: Secondary
`261QP0905X` — Clinic/Center, Public Health, State or Local Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`261QS1000X` — Clinic/Center, Student Health Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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APPALACHIAN DISTRICT HEALTH DEPARTMENT (NPI #1134980931)