Erica Teresa Merritt

Individual provider Active NPI Adult Care Home Facility · Willard, NC

NPI 1376863423 · NPPES record last updated Feb 14, 2025

Key facts

NPI
1376863423
Entity type
Individual (NPI type 1)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
FCL-082-025 (NC)
Practice address
912 Buckhorn Rd
Willard, NC 28478-9678
Phone
(910) 631-7021
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
FCL-082-017NCMDPrimary Care Clinic/Center
FCL-082-025NCMDAdult Care Home Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Family Care Home Adult Care Home Current
since Feb 23, 2025
Accepting new patients
Sereniy Family Care Home Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X FCL-082-017 NC
Adult Care Home Facility 311ZA0620X FCL-082-025 NC Yes

Addresses

Primary practice location

912 Buckhorn Rd
Willard, NC 28478-9678

Mailing address

1436 Bland School Rd
Harrells, NC 28444-7609
Phone (910) 532-4805

Other providers in Willard, NC

All providers in Willard, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.