Provider Demographics
NPI:1306826961
Name:GENESISCARE USA OF NORTH CAROLINA, PA
Entity type:Organization
Organization Name:GENESISCARE USA OF NORTH CAROLINA, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-681-2102
Mailing Address - Street 1:100 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5272
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL PARK DR STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2493
Practice Address - Country:US
Practice Address - Phone:828-253-7077
Practice Address - Fax:828-253-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2025-10-13
Deactivation Date:2019-07-11
Deactivation Code:
Reactivation Date:2019-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013EJMedicaid
NCCJ5984OtherRAILROAD MEDICARE
NC89013EJMedicaid