Parkwood Village, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-098-018 Issued in NC

Legal business name

PARKWOOD VILLAGE, LLC

Practice address

1730 Parkwood Blvd W
Wilson, NC 27893-3564

Phone

(252) 237-9050

Fax

(252) 237-9093

NPI assigned

Nov 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sally Miller

Title

Executive Director

Phone

(252) 237-9050

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1013088392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 PARKWOOD BLVD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933564",
            "telephone_number": "252-237-9050",
            "fax_number": "252-237-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 PARKWOOD BLVD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933564",
            "telephone_number": "252-237-9050",
            "fax_number": "252-237-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWOOD VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-237-9050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-098-018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805118",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Ashley Parker, M.D.
• Kayanna Parker
• Krystle Parker
• Michelle Parker, PHARMD, RPH
• Katina Jenkins Parks, PTA
• Thomas Pasquariello, PHARMD
• Monica Bharat Patel, MD
• Pathway House LLC
• Pathways Human Services of North Carolina, LLC
• Pathways to Care LLC

• Assisted Living Facility in Wilson, NC
• Providers in Wilson, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.