NPIMap

Organization Active NPI

Hertford Manor

  • Adult Care Home Facility
  • Hertford, NC
National Provider Identifier
1386044816
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
HAL072012 Issued in NC
Legal business name
HERTFORD MANOR
Practice address
464 Two Mile Desert Rd
Hertford, NC 27944-8686
Phone
(252) 402-5317
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
Courtney Blount
Title
Owner
Phone
(252) 402-5317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X HAL072012 NC Primary

Addresses

Primary practice location

464 Two Mile Desert Rd
Hertford, NC 27944-8686

Mailing address

1220 Pamlico St
Washington, NC 27889-3821
Phone (252) 402-5317

National Provider Directory

National Provider Directory
Tax ID family
Hertford Manor4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1386044816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 PAMLICO ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893821",
            "telephone_number": "252-402-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 TWO MILE DESERT RD",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279448686",
            "telephone_number": "252-402-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERTFORD MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-402-5317"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL072012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hertford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.