Graves Family Care Home 1

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-017-008 Issued in NC

Legal business name

GRAVES FAMILY CARE HOME 1

Practice address

2896 Stoney Creek School Rd
Reidsville, NC 27320-0410

Phone

(336) 421-0016

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Robin F Graves

Title

Administrator

Phone

(336) 421-0016

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386866747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2872 STONEY CREEK SCHOOL RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2896 STONEY CREEK SCHOOL RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200410",
            "telephone_number": "336-421-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVES FAMILY CARE HOME 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-421-0016",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-017-008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802217",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikia Gorham
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• Michelle Renee Gregory, RPH
• Jennifer Apple Griffin, MSN,APRN,BC,ANP,GNP
• Courtney Grooms, PA-C
• Dresden Louise Grover, COTA/L

• Adult Care Home Facility in Reidsville, NC
• Providers in Reidsville, 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 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.