SH1 Carmel Opco LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SH1 CARMEL OPCO LLC

Doing business as

The Pines on Carmel Senior Living

Practice address

5820 Carmel Rd
Charlotte, NC 28226-8106

Phone

(704) 544-4979

Fax

(704) 540-7883

NPI assigned

Oct 25, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Terri Baker

Title

Finance and Licensing Coordinator

Phone

(503) 998-5810

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Pines on Carmel Senior Living Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1215691464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 NE 82ND AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626343",
            "telephone_number": "360-254-9442",
            "fax_number": "360-254-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 CARMEL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268106",
            "telephone_number": "704-544-4979",
            "fax_number": "704-540-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH1 CARMEL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "FINANCE AND LICENSING COORDINATOR",
        "authorized_official_telephone_number": "503-998-5810",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PE-EHE5B2A5K",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TBD",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pinesoncarmel-adm@sincerisl.com",
            "affiliation": "N",
            "endpointDescription": "Administrator's email address",
            "address_1": "5820 Carmel Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282268106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Pines on Carmel Senior Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Pines on Carmel Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Charlotte, NC
• Providers in Charlotte, 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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.