NPIMap

Organization Active NPI

Mountain Trace Enterprise LLC

  • Skilled Nursing Facility
  • Sylva, NC
National Provider Identifier
1104060565
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0623 Issued in NC
Legal business name
MOUNTAIN TRACE ENTERPRISE LLC
Practice address
417 Mountain Trace Rd
Sylva, NC 28779-6779
Phone
(828) 631-1600
Fax
(828) 631-1605
NPI assigned
Apr 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Authorized official

Name
Eli Strohli
Title
Director
Phone
(305) 864-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0623 NC Primary

Addresses

Primary practice location

417 Mountain Trace Rd
Sylva, NC 28779-6779

Mailing address

417 Mountain Trace Rd
Sylva, NC 28779-6779
Phone (828) 631-1600

Other identifiers 2

IdentifierTypeStateIssuer
341-6484MedicaidNC
341-5302MedicaidNC

Other names 1

  • Mountain Trace Nursing Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1104060565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MOUNTAIN TRACE RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287796779",
            "telephone_number": "828-631-1600",
            "fax_number": "828-631-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MOUNTAIN TRACE RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287796779",
            "telephone_number": "828-631-1600",
            "fax_number": "828-631-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN TRACE ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "STROHLI",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "305-864-9191"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341-6484",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341-5302",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Trace Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylva, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.