Carolina Care Center of Cherryville, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0287 Issued in NC

Legal business name

CAROLINA CARE CENTER OF CHERRYVILLE, INC.

Practice address

111 Harrilson Rd
Cherryville, NC 28021-9541

Phone

(704) 435-4161

Fax

(704) 435-8979

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Judy Beam Beam, NHA

Title

Administrator

Phone

(704) 435-4161

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215066147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HARRILSON RD",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280219541",
            "telephone_number": "704-435-4161",
            "fax_number": "704-435-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HARRILSON RD",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280219541",
            "telephone_number": "704-435-4161",
            "fax_number": "704-435-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CARE CENTER OF CHERRYVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAM",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "BEAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-435-4161",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC NUMBER",
            "identifier": "1084030001",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405255",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Glenn Burgess, DPT
• Heidi Suzanne Cammer, FNP
• Stephanie Camp
• Tina Adams Carlton, LPTA
• Carolina Care Center
• Carolina Care Health and Rehabilitation, LLC
• Carolinas Physicians Network, Inc.
• Caromont Medical Group Inc
• Caromont Medical Group Inc
• CCJ Adult Care IV LLC

• Skilled Nursing Facility in Cherryville, NC
• Providers in Cherryville, 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 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.