Magnolia Gardens, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-0093-005 Issued in NC

Legal business name

MAGNOLIA GARDENS, INC.

Practice address

1010 E 9TH St
Roanoke Rapids, NC 27870-3046

Phone

(252) 535-5006

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kim Simpson

Title

Ceo

Phone

(252) 535-5006

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Magnolia Gardens of Warrenton Doing business as

Tax ID family

Magnolia Gardens of Warrenton2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Magnolis Gardens, Inc

  • Assisted Living Facility
  • Roanoke Rapids, NC
  • NPI 1053448522
  NPD tax ID

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043347685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2042",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278701242",
            "telephone_number": "252-535-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E 9TH ST",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703046",
            "telephone_number": "252-535-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA GARDENS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-535-5006",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-0093-005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803373",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Gardens of Warrenton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alan S Luria, MD
• Sharon Faye Lynch-Jones, FNP-C
• M&T Counseling Services PLLC
• Holly Virginia Mackenna, M.D.
• Marco Pestanas Magno, PT
• Magnolis Gardens, Inc
• Curtis Mallory
• Ravinder Mamedi, M.D.
• Vijayalakshmi Mamedi, M.D.
• Natarajan Manickam, MD

• Assisted Living Facility in Roanoke Rapids, NC
• Providers in Roanoke Rapids, 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 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.