Community Christian

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

4301 Issued in NC

Legal business name

COMMUNITY CHRISTIAN

Doing business as

Community Christian Care

Practice address

302 N 2ND Ave
Mayodan, NC 27027-2411

Phone

(336) 949-9460

Fax

(888) 371-8216

NPI assigned

Jul 12, 2018

Last updated

Jul 12, 2018By 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

Linda Smoak

Title

Administrator

Phone

(336) 949-9460

Specialties & licenses 1

Addresses

Other names 1

• Community Christian Care Doing business as

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1285110239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "STONEVILLE",
            "state": "NC",
            "postal_code": "270480760",
            "telephone_number": "336-949-9460",
            "fax_number": "888-371-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N 2ND AVE",
            "city": "MAYODAN",
            "state": "NC",
            "postal_code": "270272411",
            "telephone_number": "336-949-9460",
            "fax_number": "888-371-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CHRISTIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "SMOAK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-949-9460"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "4301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Christian Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia P. Butler, D.O.
• Nancy Wise Cameron, CPNP
• Michael Simpson Diamond
• Sandra M Ells, MD
• Everside Health Milliken Two Rivers
• Nurica Nicole Good, DDS
• Sachin K Gupta, MD

• Adult Care Home Facility in Mayodan, NC
• Providers in Mayodan, 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 Jul 12, 2018; 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.