Integrity - Patriot Living, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

INTEGRITY - PATRIOT LIVING, LLC

Doing business as

Patriot Living of Yadkinville

Practice address

409 Harrison Ave
Yadkinville, NC 27055-8248

Phone

(336) 677-1086

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Jonathan S Short

Title

Cfo

Phone

(336) 438-1381

Specialties & licenses 1

Addresses

Other names 1

• Patriot Living of Yadkinville Doing business as

Locations

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1215440813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 KOGER BLVD STE 150",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274072738",
            "telephone_number": "336-438-1383",
            "fax_number": "336-438-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 HARRISON AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558248",
            "telephone_number": "336-677-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY - PATRIOT LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-438-1381"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patriot Living of Yadkinville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke R Hull, OTA/L
• Andrew Humiston, OD
• Virginia Gatewood Hunter, PT
• Caitlin Elizabeth Hurdle Darr, FNP-C
• Natasha Hutchens
• Integrity - Pinebrook, LLC (Pinebrook Residential Center II)
• Integrity-Carolina Pines, LLC
• Integrity-Pinebrook, LLC (Carolina Pines)
• James McGrath MD, PLLC
• Suzanne M James, P.T.

• 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 Nov 18, 2021; 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.