Organization Active NPI

TRC of Salisbury, Inc.

Doing business as Magnolia Estates Skilled Care Facility

  • Skilled Nursing Facility
  • Spencer, NC
National Provider Identifier
1376510784
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0442 Issued in NC
Legal business name
TRC OF SALISBURY, INC.
Doing business as
Magnolia Estates Skilled Care Facility
Practice address
1404 S Salisbury Ave
Spencer, NC 28159-1921
Phone
(704) 633-3892
Fax
(704) 637-2784
NPI assigned
Mar 3, 2006
Last updated
Jul 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Authorized official

Name
Mr. Nick Elledge
Title
Vice President
Phone
(336) 679-8852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0442 NC Primary

Addresses

Primary practice location

1404 S Salisbury Ave
Spencer, NC 28159-1921

Mailing address

PO Box 5
Spencer, NC 28159-0005
Phone (704) 633-3892

Other identifiers 3

IdentifierTypeStateIssuer
3405288MedicaidNC
0096GOtherNCBCBS PROVIDER NO
3406433MedicaidNC

Other names 1

  • Magnolia Estates Skilled Care Facility Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1376510784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "SPENCER",
            "state": "NC",
            "postal_code": "281590005",
            "telephone_number": "704-633-3892",
            "fax_number": "704-637-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S SALISBURY AVE",
            "city": "SPENCER",
            "state": "NC",
            "postal_code": "281591921",
            "telephone_number": "704-633-3892",
            "fax_number": "704-637-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRC OF SALISBURY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-679-8852",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405288",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO",
            "identifier": "0096G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406433",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Estates Skilled Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spencer, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.