NPIMap

Organization Active NPI

Tar River LTC Group, LLC

  • Nursing Facility/Intermediate Care Facility
  • Plymouth, NC
National Provider Identifier
1184809279
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
NH0419 Issued in NC
Legal business name
TAR RIVER LTC GROUP, LLC
Practice address
1084 US Highway 64 E
Plymouth, NC 27962-9215
Phone
(252) 793-2100
Fax
(252) 793-1243
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Norwood Randolph Uzzell
Title
President
Phone
(252) 523-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NH0419 NC Primary

Addresses

Primary practice location

1084 US Highway 64 E
Plymouth, NC 27962-9215

Mailing address

1084 US Highway 64 E
Plymouth, NC 27962-9215
Phone (252) 793-2100

Other identifiers 2

IdentifierTypeStateIssuer
7806621MedicaidNC
7805286MedicaidNC

Other names 1

  • Roanoke Landing Nursing and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1184809279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 US HIGHWAY 64 E",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279629215",
            "telephone_number": "252-793-2100",
            "fax_number": "252-793-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 US HIGHWAY 64 E",
            "city": "PLYMOUTH",
            "state": "NC",
            "postal_code": "279629215",
            "telephone_number": "252-793-2100",
            "fax_number": "252-793-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAR RIVER LTC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "UZZELL",
        "authorized_official_first_name": "NORWOOD",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-523-9094"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7806621",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805286",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roanoke Landing Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.