Ncal-Cherryville, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-036017 Issued in NC

Legal business name

NCAL-CHERRYVILLE, INC.

Doing business as

Somerset Court of Cherryville

Practice address

401 W Academy St
Cherryville, NC 28021-3101

Phone

(704) 445-1554

Fax

(704) 445-1501

NPI assigned

Dec 11, 2006

Last updated

Jan 10, 2014By 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. William Benton

Title

Ceo

Phone

(336) 724-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Somerset Court of Cherryville Doing business as

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1386704336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BROOKSTOWN AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012524",
            "telephone_number": "336-724-1000",
            "fax_number": "336-724-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W ACADEMY ST",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280213101",
            "telephone_number": "704-445-1554",
            "fax_number": "704-445-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCAL-CHERRYVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-724-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-036017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804013",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerset Court of Cherryville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harsha Mirchandani, MPT
• Bill Eugene Moses Jr., PTA
• Natalie Allison Moss, CFTS
• Timothy Craft Moss, CFTS
• Stephanie Randall Mulvey, RPH.
• Sydni Rhea Noble, FNP-C
• Our Home at Home
• April Lynn Palmer, PTA
• Lesa Parker, LPTA
• Divyesh Kishorkumar Patel, MS, RPH.

• Adult Care Home Facility in Cherryville, NC
• Providers in Cherryville, 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 Jan 10, 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.