Autumn Wind

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL082012 Issued in NC

Legal business name

AUTUMN WIND

Practice address

507 W Pinewood St
Roseboro, NC 28382-5259

Phone

(910) 525-4082

Fax

(910) 525-4059

NPI assigned

Jun 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jesse Chad Stewart

Title

Administrator

Phone

(910) 525-4082

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457556458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 W PINEWOOD ST",
            "city": "ROSEBORO",
            "state": "NC",
            "postal_code": "283825259",
            "telephone_number": "910-525-4082",
            "fax_number": "910-525-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W PINEWOOD ST",
            "city": "ROSEBORO",
            "state": "NC",
            "postal_code": "283825259",
            "telephone_number": "910-525-4082",
            "fax_number": "910-525-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN WIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-525-4082",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL082012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321ECS57",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walid Aawar, DDS
• Atlantic Radiology Associates
• Bio-Medical Applications of North Carolina, Inc.
• Marinda Carraway, CNM
• La'Kesia April-Samoan Chance, CNA
• Coastal Carolina ABA, LLC
• Sydney Evans

• Assisted Living Facility in Roseboro, NC
• Providers in Roseboro, 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 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.