Magnolia Place

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

FCL-030-002 Issued in NC

Legal business name

MAGNOLIA PLACE

Practice address

270 Duke St
Mocksville, NC 27028-2504

Phone

(336) 751-2214

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Lane Morris

Title

Administrator

Phone

(336) 751-2214

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215064431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 DUKE ST",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282504",
            "telephone_number": "336-751-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 DUKE ST",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282504",
            "telephone_number": "336-751-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-751-2214",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "FCL-030-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FCL-030-002",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Shawntae Lackey, OTR/L
• Steven G Laymon, OD
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• Londry & Modlin Xix DDS PLLC
• Lindsey Lowtharpe, LCSW
• Brett Allen Malloy, PT
• Cathy Manson, MED, RD, LDN
• Marlin Chiropractic Center PLLC
• Brandie Marlin, D.C.
• Alejandra Martinez

• Health Maintenance Organization in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Health Maintenance Organization 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.