Ncal- Mockville, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-030-004 Issued in NC

Legal business name

NCAL- MOCKVILLE, INC.

Doing business as

Somerset Court of Mocksville

Practice address

150 Ken Dwiggins Dr
Mocksville, NC 27028-2439

Phone

(336) 751-1209

Fax

(336) 751-0601

NPI assigned

Dec 27, 2006

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

• Somerset Court of Mocksville 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": "1114082419",
    "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": "150 KEN DWIGGINS DR",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282439",
            "telephone_number": "336-751-1209",
            "fax_number": "336-751-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCAL- MOCKVILLE, 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-030-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805398",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerset Court of Mocksville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monarch
• Holly Moody, MS, OTR/L
• Loretta Morris, RMA/CMA, CNA, MT
• Seavon Munoz, DO
• N. Kephart DDS PLLC
• New Beginnings Family Services
• New Beginnings Family Services
• Jessica Eleanor Newman, PA-C
• Andora Nicholson, FNP-C
• North Carolina Early Intervention, LLC

• Adult Care Home Facility in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Adult Care Home Facility in North Carolina

• 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.