Organization Active NPI

Kannapolis Holdings LLC

Doing business as Kannapolis Village

  • Assisted Living Facility
  • Kannapolis, NC
National Provider Identifier
1467588699
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL013033 Issued in NC
Legal business name
KANNAPOLIS HOLDINGS LLC
Doing business as
Kannapolis Village
Practice address
1516 Pine St
Kannapolis, NC 28081-4142
Phone
(704) 932-8900
Fax
(704) 938-9334
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kenneth Hodges
Title
Member Manager
Phone
(828) 738-3046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL013033 NC Primary

Addresses

Primary practice location

1516 Pine St
Kannapolis, NC 28081-4142

Mailing address

1516 Pine St
PO Box 550
Kannapolis, NC 28081-4142
Phone (704) 932-8900

Other identifiers 1

IdentifierTypeStateIssuer
7805585MedicaidNC

Other names 1

  • Kannapolis Village Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467588699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 PINE ST",
            "address_2": "PO BOX 550",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814142",
            "telephone_number": "704-932-8900",
            "fax_number": "704-938-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 PINE ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280814142",
            "telephone_number": "704-932-8900",
            "fax_number": "704-938-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANNAPOLIS HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "828-738-3046"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL013033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805585",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kannapolis Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kannapolis, NC

Sources for this page

  • 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.