Elizabethtown Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0328 Issued in NC

Legal business name

ELIZABETHTOWN NURSING CENTER, INC.

Practice address

208 Mercer Rd
Elizabethtown, NC 28337-3938

Phone

(910) 862-8181

Fax

(910) 862-4860

NPI assigned

Mar 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Nick Elledge

Title

Vice President

Phone

(336) 679-8852

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073580957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283371449",
            "telephone_number": "910-862-8181",
            "fax_number": "910-862-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MERCER RD",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283373938",
            "telephone_number": "910-862-8181",
            "fax_number": "910-862-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETHTOWN NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-679-8852",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO",
            "identifier": "00845",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415210",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406260",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Duncan
• Jessica Lauren Eason, LPC
• Amber Eddy, AGNP
• Amy Hamilton Edwards
• Franklin D Egolf Jr., PSYD
• Elizabethtown Rescue Squad
• Danny L Ellis Jr., D.C.
• Elwell Ferry Inpatient Services
• Julie Taylor Evans, PHARMD
• Shannon Evans, P.A.

• All providers in Elizabethtown, NC
• Skilled Nursing 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.