Countryside Village LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COUNTRYSIDE VILLAGE LLC

Practice address

5383 US Highway 117 N
Pikeville, NC 27863-9443

Phone

(919) 242-6369

Fax

(919) 242-9884

NPI assigned

Jun 2, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Michael Chryll Bateman

Title

President

Phone

(336) 917-4799

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1295029791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 PRIMROSE AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274083192",
            "telephone_number": "336-617-4799",
            "fax_number": "336-617-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5383 US HIGHWAY 117 N",
            "city": "PIKEVILLE",
            "state": "NC",
            "postal_code": "278639443",
            "telephone_number": "919-242-6369",
            "fax_number": "919-242-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "BATEMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHRYLL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-917-4799",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C&E Assisted Living, Inc (Pikeville Assisted Living)
• Kandi Renae Campbell, MD
• Dana Cea
• Kendra Kristine Core, PA
• Countryside Living
• Christina Danielle Dixon
• Eastern Medical Associates, PA
• Empowered Approach, LLC
• Faithful Family Care
• Faithful Family Care Home

• Assisted Living Facility in Pikeville, NC
• Providers in Pikeville, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.