Organization Active NPI

RGM Al Holdings, LLC

  • Adult Care Home Facility
  • North Wilkesboro, NC
National Provider Identifier
1033568258
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
RGM AL HOLDINGS, LLC
Practice address
240 Independence Ave
North Wilkesboro, NC 28659
Phone
(828) 244-5266
NPI assigned
Jun 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Charles E Trefzger
Title
Manager
Phone
(828) 322-5535

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL097015 NC
Adult Care Home Facility 311ZA0620X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

240 Independence Ave
North Wilkesboro, NC 28659

Mailing address

328 1St Ave NW
Hickory, NC 28601-6123
Phone (828) 322-5535

Other names 1

  • Rose Glen Manor Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2130092Rose Glen Manor240 Independence Avenue, North Wilkesboro, NC 28659Certificate of waiverMay 1, 2027

National Provider Directory

National Provider Directory

Locations

328 1st Ave NW
Hickory, NC 28601

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1033568258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 1ST AVE NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286016123",
            "telephone_number": "828-322-5535",
            "fax_number": "828-326-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 INDEPENDENCE AVE",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "28659",
            "telephone_number": "828-244-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RGM AL HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL097015",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rose Glen Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rose Glen Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.