Magnolia Place of New Bern, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-025-019 Issued in NC

Legal business name

MAGNOLIA PLACE OF NEW BERN, LLC

Practice address

3407 Oaks Rd
New Bern, NC 28560-2718

Phone

(252) 633-1143

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Roy L Holt

Title

Managing Member

Phone

(252) 633-3455

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477638856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1487",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272851487",
            "telephone_number": "336-595-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 OAKS RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285602718",
            "telephone_number": "252-633-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PLACE OF NEW BERN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "252-633-3455"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-025-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804337",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Tuttle Macmoran, LCMHC
• Joshua Miles Macnaughton, DPT
• Laurel J Magee-Linch, PT
• Jennifer Magee, M.S., CCC-SLP
• Magnolia Medical Marketing Dba Magnolia Wellness
• John Philip Mahaney Jr., MD
• Jessica Neil Maier, M.S. CCC-SLP
• Majors Support Services, LLC
• Michael John Malishewsky, R.PH.
• Hailey Malsch, OTR/L

• 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 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.