Mount Eagle Health Care - Clemmons, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

HC1587 Issued in NC

Legal business name

MOUNT EAGLE HEALTH CARE - CLEMMONS, LLC

Practice address

2554 Lewisville Clemmons Rd # 306
Clemmons, NC 27012-8110

Phone

(336) 934-4227

NPI assigned

Nov 12, 2015

Organization subpart

No

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

Authorized official

Name

Bahati N Simtaji

Title

Director

Phone

(336) 934-4227

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1043683188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE CLEMMONS RD # 306",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128110",
            "telephone_number": "336-934-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE CLEMMONS RD # 306",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128110",
            "telephone_number": "336-934-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT EAGLE HEALTH CARE - CLEMMONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "SIMTAJI",
        "authorized_official_first_name": "BAHATI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-934-4227"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC1587",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC1587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mornad Health PLLC
• Kathryn Dudley Morris, LCSW
• Melissa J Morrissette-Hurst, LCSWA
• Abigail Mosqueda, RBT
• Mahala Motzny, MS/EDS
• Mountain Ridge Counseling PLLC
• Mt Physical Therapy, LLC
• Multi-Therapeutic Services, Inc
• Multi-Therapeutic Services, Inc.
• Meghan Elizabeth Elaine Mutter

• Nursing Care Agency in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Nursing Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.