Avante at Wilson, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0272 Issued in NC

Legal business name

AVANTE AT WILSON, INC.

Practice address

1804 Forest Hills Rd W
Wilson, NC 27893-3413

Phone

(252) 237-8161

Fax

(252) 237-0447

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dean J Dickmann

Title

President

Phone

(954) 987-7180

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1295810240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD",
            "address_2": "SUITE 540 NORTH",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216751",
            "telephone_number": "954-987-7180",
            "fax_number": "954-989-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933413",
            "telephone_number": "252-237-8161",
            "fax_number": "252-237-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTE AT WILSON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "DICKMANN",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-987-7180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0272",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425063",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416213",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wilson, NC
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.