Organization Active NPI

Tom & Jerry Management, LLC

  • Assisted Living Facility
  • Huntersville, NC
National Provider Identifier
1316061534
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL-060-014 Issued in NC
Legal business name
TOM & JERRY MANAGEMENT, LLC
Practice address
111 South Church Street
Huntersville, NC 28078
Phone
(704) 875-0859
Fax
(704) 948-0763
NPI assigned
Mar 16, 2007
Last updated
Feb 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Jerry Ronald Chapman
Title
Owner/Manager Member
Phone
(336) 408-8140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL-060-014 NC Primary

Addresses

Primary practice location

111 South Church Street
Huntersville, NC 28078

Mailing address

PO Box 686
Huntersville, NC 28070-0686
Phone (704) 875-0859

Other identifiers 1

IdentifierTypeStateIssuer
7801658MedicaidNC

Other names 1

  • Tom & Jerry Enterprises, Former legal business name

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1316061534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280700686",
            "telephone_number": "704-875-0859",
            "fax_number": "704-948-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH CHURCH STREET",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "28078",
            "telephone_number": "704-875-0859",
            "fax_number": "704-948-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM & JERRY MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "OWNER/MANAGER MEMBER",
        "authorized_official_telephone_number": "336-408-8140"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-060-014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801658",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tom & Jerry Enterprises,",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.