Kingswood Nursing Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

KINGSWOOD NURSING CENTER INC

Doing business as

KingsWood Nursing Center

Practice address

797 Pee Dee Rd
Aberdeen, NC 28315-3830

Phone

(910) 944-8999

Fax

(910) 944-0809

NPI assigned

Aug 10, 2005

Last updated

Jul 18, 2019By 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

Robert Hagan

Title

President

Phone

(770) 993-4000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KingsWood Nursing Center Doing business as

Locations

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1134121106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 CANTON ST STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754240",
            "telephone_number": "770-993-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 PEE DEE RD",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "283153830",
            "telephone_number": "910-944-8999",
            "fax_number": "910-944-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSWOOD NURSING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "HAGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-993-4000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415509",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KingsWood Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KingsWood Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Aberdeen, NC
• Providers in Aberdeen, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.