Mecklenburg Health Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0570 Issued in NC

Legal business name

MECKLENBURG HEALTH CARE CENTER, INC.

Doing business as

Mecklenburg Health & Rehabilitation Center

Practice address

2415 Sandy Porter Rd
Charlotte, NC 28273-3695

Phone

(704) 583-0430

Fax

(704) 583-0433

NPI assigned

Oct 3, 2006

Last updated

Oct 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Claude Novel Martin III

Title

Cfo, Mfa Inc. General Partner

Phone

(540) 776-7526

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mecklenburg Health & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1265526404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 PENN FOREST BLVD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184374",
            "telephone_number": "540-989-3618",
            "fax_number": "540-774-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 SANDY PORTER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282733695",
            "telephone_number": "704-583-0430",
            "fax_number": "704-583-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "NOVEL",
        "authorized_official_title_or_position": "CFO, MFA INC. GENERAL PARTNER",
        "authorized_official_telephone_number": "540-776-7526",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0570",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340610E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405471",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mecklenburg Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Charlotte, NC
• Providers in Charlotte, 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 Oct 23, 2013; 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.