Premier Operating Croatan, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PREMIER OPERATING CROATAN, LLC

Practice address

4522 Old Cherry Point Rd
New Bern, NC 28560-8012

Phone

(252) 634-9066

Fax

(252) 634-1862

NPI assigned

May 10, 2016

Organization subpart

Yes

Parent organization

PREMIER SENIOR LIVING, LLCAs reported in NPPES

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

Authorized official

Name

Robert Borsody

Title

Principal

Phone

(212) 739-0794

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1336595255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 OLD CHERRY POINT RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285608012",
            "telephone_number": "252-634-9066",
            "fax_number": "252-634-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 OLD CHERRY POINT RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285608012",
            "telephone_number": "252-634-9066",
            "fax_number": "252-634-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER OPERATING CROATAN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER SENIOR LIVING, LLC",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "BORSODY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "212-739-0794"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Jay Scott Powell
• Juziyia Shontell Powell
• Satydra Sha-Neek Powell, APRN
• Hannah Powers
• Margaret (Ann) Powers
• Joseph Vann Presson, OD
• Amanda Marie Price, LPCA
• Amy Lynn Price, PTA
• Lexi Aaron Price
• Tracy C Price, M.ED., LPC, NCC

• Adult Care Home Facility in New Bern, NC
• Providers in New Bern, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.