NPIMap

Organization Active NPI

Senior Care of Goldsboro, Inc

  • Assisted Living Facility
  • Goldsboro, MD
National Provider Identifier
1295077105
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
05AL0046-A Issued in MD
Legal business name
SENIOR CARE OF GOLDSBORO, INC
Practice address
14736 Poplar St
Goldsboro, MD 21636-1307
Phone
(410) 924-7360
Fax
(410) 482-9307
NPI assigned
Mar 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
Mrs. Tammy Merson, RNNPI 1235578261
Title
Owner, Manager
Phone
(410) 924-7360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 05AL0046-A MD Primary

Addresses

Primary practice location

14736 Poplar St
Goldsboro, MD 21636-1307

Mailing address

14736 Poplar St
Goldsboro, MD 21636-1307
Phone (410) 924-7360

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1295077105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14736 POPLAR ST",
            "city": "GOLDSBORO",
            "state": "MD",
            "postal_code": "216361307",
            "telephone_number": "410-924-7360",
            "fax_number": "410-482-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14736 POPLAR ST",
            "city": "GOLDSBORO",
            "state": "MD",
            "postal_code": "216361307",
            "telephone_number": "410-924-7360",
            "fax_number": "410-482-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE OF GOLDSBORO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "MERSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OWNER, MANAGER",
        "authorized_official_telephone_number": "410-924-7360",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "05AL0046-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.