The Heritage of Cedar Rock

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-030-007 Issued in NC

Legal business name

THE HERITAGE OF CEDAR ROCK

Practice address

191 Crestview Dr
Mocksville, NC 27028-2643

Phone

(336) 751-1515

Fax

(336) 751-1621

NPI assigned

May 7, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Charles Vann Pierce

Title

Owner

Phone

(336) 643-0555

Specialties & licenses 2

Addresses

Other identifiers 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": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1265608467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "OAK RIDGE",
            "state": "NC",
            "postal_code": "273100878",
            "telephone_number": "336-643-0555",
            "fax_number": "336-643-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CRESTVIEW DR",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282643",
            "telephone_number": "336-751-1515",
            "fax_number": "336-751-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HERITAGE OF CEDAR ROCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "VANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-643-0555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL030007",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-030-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7806011",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Mocksville, NC
• Providers in Mocksville, 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 Jun 26, 2013; 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.