Mountain Vista Health Park, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MOUNTAIN VISTA HEALTH PARK, INC.

Doing business as

Mountain Vista Health Park

Practice address

106 Mt Vista Rd
Denton, NC 27239-8793

Phone

(336) 859-2181

Fax

(336) 859-4053

NPI assigned

Aug 5, 2006

Last updated

Feb 24, 2012By 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

Mrs. Kathy B McDonald

Title

Administrator

Phone

(336) 859-2181

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MOUNTAIN VISTA HEALTH PARK Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396754875. Details of each certification follow.

• CCN 345196 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 345196

Legal name

MOUNTAIN VISTA HEALTH PARK, INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 4, 1980

Last certification

May 1, 2025

Beds

120 (60 certified)

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 30, 1971 in NC

Enrollment address

106 Mount Vista Rd
Denton, NC 27239-8793

Nursing home name

MOUNTAIN VISTA HEALTH PARK

Listed as

Mountain Vista Health ParkCCN 345196 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Feb 4, 1980

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6052.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Mountain Vista Health Park2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mountain Vista Health Park, Inc.

  dba Mountain Vista Health Park

  • Adult Care Home Facility
  • Denton, NC
  • NPI 1710997804
  NPD tax ID

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clifton A Baker, MD

  • General Practice Physician
  • Denton, NC
  • NPI 1053370098
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Clifton A Baker, MD

  • General Practice Physician
  • Denton, NC
  • NPI 1053370098

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1396754875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "DENTON",
            "state": "NC",
            "postal_code": "272391547",
            "telephone_number": "336-859-2181",
            "fax_number": "336-859-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MT VISTA RD",
            "city": "DENTON",
            "state": "NC",
            "postal_code": "272398793",
            "telephone_number": "336-859-2181",
            "fax_number": "336-859-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA HEALTH PARK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-859-2181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405196",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406191",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNTAIN VISTA HEALTH PARK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Logan
• Olivia Lorenz, OTA
• Felizardo Hocbo Mangundayao, MD
• Wendy Sutts McLeod, M. ED.
• Misty Nichols Mize, LCSW
• Mountain Vista Health Park, Inc. (Mountain Vista Health Park)
• NH Med Operator LLC
• NH Med Services LLC
• NH Med Services, LLC
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #07328)

• Skilled Nursing Facility in Denton, NC
• Providers in Denton, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.