Cypress Glen Retirement Community

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0473 Issued in NC

Legal business name

CYPRESS GLEN RETIREMENT COMMUNITY

Practice address

100 Hickory Street
Greenville, NC 27585-1637

Phone

(252) 830-0036

Fax

(252) 830-0411

NPI assigned

Dec 1, 2005

Last updated

Aug 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Donald E. Metzger Sr.

Title

Chairman of the Board

Phone

(910) 738-4652

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1053395335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HICKORY STREET",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "275851637",
            "telephone_number": "252-830-0036",
            "fax_number": "252-830-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HICKORY STREET",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "275851637",
            "telephone_number": "252-830-0036",
            "fax_number": "252-830-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS GLEN RETIREMENT COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "METZGER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "910-738-4652",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLIE CROSS AND BLUE SHILE",
            "identifier": "009CH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kayla Cyphert, AUD
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• Richard Concezio D'Alonzo, M.D.
• Gabrielle Ann D'Amato
• Emma Caroline Daas, CCC-SLP
• Sevdalina Metodieva Dabova-Missova, MD

• Skilled Nursing Facility in Greenville, NC
• Providers in Greenville, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.