Ncal - Rocky Mount, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-064-010 Issued in NC

Legal business name

NCAL - ROCKY MOUNT, INC.

Doing business as

Somersert Court of Rocky Mount

Practice address

918 Westwood Dr
Rocky Mount, NC 27803-2532

Phone

(252) 443-5592

Fax

(252) 446-6969

NPI assigned

Dec 27, 2006

Last updated

Nov 8, 2013By 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

William Benton

Title

Ceo

Phone

(336) 724-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Somersert Court of Rocky Mount Doing business as

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1083779383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BROOKSTOWN AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012524",
            "telephone_number": "336-724-1000",
            "fax_number": "336-724-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 WESTWOOD DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278032532",
            "telephone_number": "252-443-5592",
            "fax_number": "252-446-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCAL - ROCKY MOUNT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-724-1000"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-064-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804017",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somersert Court of Rocky Mount",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.