The Ivy at Clemmons LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE IVY AT CLEMMONS LLC

Practice address

6010 Meadowbrook Mall CT
Clemmons, NC 27012-9266

Phone

(336) 766-8050

NPI assigned

Oct 23, 2018

Last updated

Oct 23, 2018By 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

Batya Gorelick

Title

VP of Administrative Services the C

Phone

(336) 766-8050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1427524917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SYLVAN AVE STE 240",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 MEADOWBROOK MALL CT",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129266",
            "telephone_number": "336-766-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE IVY AT CLEMMONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "GORELICK",
        "authorized_official_first_name": "BATYA",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE SERVICES THE C",
        "authorized_official_telephone_number": "336-766-8050"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.