Yadkin Nursing Care Center, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-099-011 Issued in NC

Legal business name

YADKIN NURSING CARE CENTER, INC.

Doing business as

The Magnolias Over Yadkin

Practice address

903 W Main St
Yadkinville, NC 27055-7807

Phone

(336) 679-8863

Fax

(336) 679-3009

NPI assigned

Mar 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Nick Elledge

Title

Vice President

Phone

(336) 679-8852

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Magnolias Over Yadkin Doing business as

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174590608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270550879",
            "telephone_number": "336-679-8863",
            "fax_number": "336-679-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MAIN ST",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270557807",
            "telephone_number": "336-679-8863",
            "fax_number": "336-679-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YADKIN NURSING CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-679-8852",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-099-011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804193",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Magnolias Over Yadkin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Lynn Wyngaard, APNP
• Yadkin County Council on Aging, Inc.
• Yadkin County DSS
• Yadkin County Schools
• Yadkin Dialysis Center of Wake Forest University (Yadkin Dialysis Center)
• Yadkin Nursing Care Center, Inc.
• Yadkin Physical Therapy, L.L.C.
• Yadkin Senior Services, Inc.
• Yadkin Vision Center O.D., PLLC
• Yadkin Vision Center, OD PA

• Adult Care Home Facility in Yadkinville, NC
• Providers in Yadkinville, 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 Aug 22, 2020; 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.