NC Dept of Military and Veterans Affairs NC Division of Veterans Af

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0616 Issued in NC

Legal business name

NC DEPT OF MILITARY AND VETERANS AFFAIRS NC DIVISION OF VETERANS AF

Practice address

1601 Brenner Ave Building 10
Salisbury, NC 28144-2515

Phone

(704) 638-4200

Fax

(704) 636-4576

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2024By 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

Brian C Pierce

Title

Chief Deputy Secretary

Phone

(984) 204-8333

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407930936. Details of each certification follow.

• CCN 345531 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 345531

Legal name

NC DEPT OF MILITARY AND VETERANS AFFAIRS NC DIVISION OF VETER AFFAIRS

Doing business as

NC STATE VETERANS HOME - SALISBURY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 22, 2004

Last certification

Aug 8, 2024

Beds

99

Ownership / control type

State

Organization structure

GovernmentNon-profit

Enrollment address

1601 Brenner Ave
BLDG 10
Salisbury, NC 28144-2515

Nursing home name

NC STATE VETERANS HOME - SALISBURY

Listed as

NC State Veterans Home - SalisburyCCN 345531 · All quality measures

Overall star rating

4 of 5

Health inspections

2 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Government - State

Certified

Nov 22, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9983.2 residents per day on average

Penalties (3 years)

1Fines totaling $12,444

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Dept of Administration Ncdva2 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.

• NC Dept of Military and Veterans Affairs NC Division of Veterans Affai

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1871508408
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• NC Dept of Military and Veterans Affairs NC Division of Veterans Affai

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1871508408

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 3

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

Affiliated clinicians 1

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

• Chetan N Amin, DO

  • Family Medicine Physician
  • Salisbury, NC
  • NPI 1104892249

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1407930936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 MAIL SERVICE CENTER",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276994000",
            "telephone_number": "984-204-8333",
            "fax_number": "984-204-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE BUILDING 10",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-4200",
            "fax_number": "704-636-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC DEPT OF MILITARY AND VETERANS AFFAIRS NC DIVISION OF VETERANS AF",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-08-22",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF DEPUTY SECRETARY",
        "authorized_official_telephone_number": "984-204-8333"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405531",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "NC0616",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Denise Nash, M.A., CCC-SLP
• Natalie Spinella PLLC
• National Vision Inc (America's Best Contacts & Eyeglasses)
• Hally Nave, OTR
• Nazareth Children's Home (Carolina Counseling and Consultation)
• Alan Vann Nealeans, DDS
• Martha J Neathery, MSW,LCSW
• Angela Vernette Neely, LPTA
• Jeffry Marshall Neil, MD
• Felice Nelson, LPN

• Skilled Nursing Facility in Salisbury, NC
• Providers in Salisbury, 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 Aug 22, 2024; 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.