Fve SE Home Place New Bern LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-025-032 Issued in NC

Legal business name

FVE SE HOME PLACE NEW BERN LLC

Doing business as

Homeplace of New Bern

Practice address

1309 McCarthy Blvd
New Bern, NC 28562-2035

Phone

(252) 637-7133

Fax

(252) 637-7332

NPI assigned

Jul 22, 2011

Last updated

Mar 28, 2019By 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

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other names 1

• Homeplace of New Bern Doing business as

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1457639668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582094",
            "telephone_number": "617-796-8387",
            "fax_number": "617-796-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 MCCARTHY BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622035",
            "telephone_number": "252-637-7133",
            "fax_number": "252-637-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FVE SE HOME PLACE NEW BERN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-025-032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homeplace of New Bern",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Homeplace of New Bern",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael McGraw Fujimagari, MD
• Jared Whitford Fulcher, PTA
• Wendy Sue Fulford, NP
• Christine Lynn Fulk, RN
• Jessica Ashton Fuller, MSW, LCSW, LCAS,CCTP
• G. Anesthesia, PLLC
• Daniel Wendell Gabier, D.O.
• Rebecca B Gaeta, LMFT
• Olivia Galvao
• Payton Galvin

• Assisted Living Facility in New Bern, NC
• Providers in New Bern, 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 Mar 28, 2019; 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.