Bradford Village of Kernersville East, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-034-068 Issued in NC

Legal business name

BRADFORD VILLAGE OF KERNERSVILLE EAST, LLC

Practice address

413 N Main St
Kernersville, NC 27284-2643

Phone

(336) 993-4696

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By 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

Ronald F McManus

Title

Managing Member

Phone

(704) 996-7443

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Paul Joseph Keane, DPM

  • Podiatrist
  • Bryson City, NC
  • NPI 1194829838
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326123076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1487",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272851487",
            "telephone_number": "336-595-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 N MAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842643",
            "telephone_number": "336-993-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD VILLAGE OF KERNERSVILLE EAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "704-996-7443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-034-068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804975",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mekaila Bostic, MS, LCMHCA
• Karen Elina Bowen, DO
• Kendra Johnson Bowers, PHARMD
• Hannah Marion Bowser, OD
• Cassie Marie Boyd
• Bradford Village of Kernersville West, LLC
• Alison Maureen Bradley
• Candace Angelena Bradley, D.O.
• Sierra Bradner
• Aidan Bradshaw

• Assisted Living Facility in Kernersville, NC
• Providers in Kernersville, 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 Aug 22, 2020; 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.