NPIMap

Organization Active NPI

Glencare Assisted Living, Inc Dba

Doing business as Glencare of Wilmington

  • Assisted Living Facility
  • Wilmington, NC
National Provider Identifier
1033230875
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GLENCARE ASSISTED LIVING, INC DBA
Doing business as
Glencare of Wilmington
Practice address
4200 Jasmine Cove Way
Wilmington, NC 28412-2099
Phone
(910) 275-0058
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Marian Anne Kornegay, R.N. NHA V.P.
Title
Vice President
Phone
(910) 275-0058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4200 Jasmine Cove Way
Wilmington, NC 28412-2099

Mailing address

210 Limestone Rd
P.O. Box 339
Kenansville, NC 28349-9031
Phone (910) 275-0058

Other names 1

  • GLENCARE OF WILMINGTON Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glencare Assisted Living Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033230875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LIMESTONE RD",
            "address_2": "P.O. BOX 339",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283499031",
            "telephone_number": "910-275-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 JASMINE COVE WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122099",
            "telephone_number": "910-275-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENCARE ASSISTED LIVING, INC DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KORNEGAY",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "910-275-0058",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N. NHA V.P."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENCARE OF WILMINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.