Organization Active NPI

Slay' Rest Home

  • Clinic/Center
  • Charlotte, NC
National Provider Identifier
1407047343
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HAL 060-038 Issued in NC
Legal business name
SLAY' REST HOME
Practice address
2920 Cindy LN
Charlotte, NC 28269-4213
Phone
(704) 509-9132
Fax
(704) 596-8401
NPI assigned
Aug 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Phyllis Miller Slay
Title
Administrator
Phone
(704) 596-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HAL 060-038 NC Primary

Addresses

Primary practice location

2920 Cindy LN
Charlotte, NC 28269-4213

Mailing address

2920 Cindy LN
Charlotte, NC 28269-4213
Phone (704) 596-8401

Other identifiers 1

IdentifierTypeStateIssuer
7803805MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1407047343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 CINDY LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694213",
            "telephone_number": "704-596-8401",
            "fax_number": "704-596-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 CINDY LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694213",
            "telephone_number": "704-509-9132",
            "fax_number": "704-596-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLAY' REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "SLAY",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-596-8401"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "HAL 060-038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803805",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.