Woodland Place Management, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-034-073 Issued in NC

Legal business name

WOODLAND PLACE MANAGEMENT, INC

Doing business as

Woodland Place - Clemmons

Practice address

6010 Meadowbrook Mall CT
Clemmons, NC 27012-9266

Phone

(336) 766-8050

Fax

(336) 766-8054

NPI assigned

Mar 15, 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

Mr. Selby Russell Jones

Title

President

Phone

(919) 829-2499

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodland Place - Clemmons Doing business as

Tax ID family

Woodland Place - Clemmons2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Woodland Place Management, Inc

  dba Woodland Place - Greensboro

  • Assisted Living Facility
  • Greensboro, NC
  • NPI 1043344609
  NPD tax ID

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346374980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 MEADOWBROOK MALL CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129266",
            "telephone_number": "336-766-8050",
            "fax_number": "336-766-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 MEADOWBROOK MALL CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129266",
            "telephone_number": "336-766-8050",
            "fax_number": "336-766-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND PLACE MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SELBY",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-829-2499",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-034-073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805244",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Place - Clemmons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Kirk Williard, LPC
• Robert A Willis, DMD
• Dana R Winn, MD
• Stephen Bradley Winter, MD
• Elizabeth Witt, M.S. CCC-SLP
• Amy R Woodruff
• Maureenrita O'Toole Work, D.C.
• Wray Hand Surgery PLLC
• Walter H Wray, MD
• Amy Howell Wren, CNM

• Assisted Living Facility in Clemmons, NC
• Providers in Clemmons, 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.