Moyers Assisted Living Compassionate LLC

Key facts

NPI

1124665245

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility 310400000X

Legal business name

MOYERS ASSISTED LIVING COMPASSIONATE LLC

Practice address

5767 NC Highway 135
Stoneville, NC 27048-8477

Phone

(336) 445-4004

Fax

(336) 445-0148

NPI assigned

Dec 9, 2019

Organization subpart

No

Authorized official

Name

Coky A Kernodle, ADMINISTRATOR NPI 1316596364

Title

Owner/Administrator

Phone

(336) 327-9438

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Coky Ann Kernodle, ADMINISTRATOR Nursing Home Administrator · Stoneville, NC · NPI 1316596364
  NPD Authorized official

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 9, 2019.

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1124665245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 NC HIGHWAY 135",
            "city": "STONEVILLE",
            "state": "NC",
            "postal_code": "270488477",
            "telephone_number": "336-445-4004",
            "fax_number": "336-445-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5767 NC HIGHWAY 135",
            "city": "STONEVILLE",
            "state": "NC",
            "postal_code": "270488477",
            "telephone_number": "336-445-4004",
            "fax_number": "336-445-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOYERS ASSISTED LIVING COMPASSIONATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "KERNODLE",
        "authorized_official_first_name": "COKY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "336-327-9438",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneville, NC

• Coky Ann Kernodle, ADMINISTRATOR
• Amy Lester, ITFS
• Lisa Lee McShane Lloyd, LCAS
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All providers in Stoneville, NC · Assisted Living Facility in North Carolina