Walnut Ridge Assistd Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL 085 005 Issued in NC

Legal business name

WALNUT RIDGE ASSISTD LIVING

Practice address

411 Windmill St
Walnut Cove, NC 27052-7705

Phone

(336) 591-7790

NPI assigned

Mar 9, 2007

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

Ms. Karen Hicks

Title

Executive Director

Phone

(336) 591-7790

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326179359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WINDMILL ST",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270527705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WINDMILL ST",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270527705",
            "telephone_number": "336-591-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT RIDGE ASSISTD LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-591-7790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL 085 005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803627",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Anne Townsend, LCSWA
• Robert F Turner III, PHARMD
• Walnut Cove Healthcare LLC (Walnut Cove Health and Rehabilitation Center)
• Walnut Cove Pharmacy Inc (Family Pharmacy)
• Walnut Cove Pharmacy, Inc
• Nicholas Bradford Watts, PHARMD
• Wellspring Family Medicine, PA
• Brittany Wingate
• Youth Haven Services, Inc.

• Assisted Living Facility in Walnut Cove, NC
• Providers in Walnut Cove, 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.