NPIMap

Organization Active NPI

Beverly Rucker Family Care Home #4

  • Assisted Living Facility
  • Reidsville, NC
National Provider Identifier
1477683084
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BEVERLY RUCKER FAMILY CARE HOME #4
Practice address
723 Frank Rd
Reidsville, NC 27320-8699
Phone
(336) 613-1552
Fax
(336) 349-2873
NPI assigned
Mar 6, 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
Mrs. Beverly Lawson Rucker
Title
Administrator
Phone
(336) 613-1552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

723 Frank Rd
Reidsville, NC 27320-8699

Mailing address

1123 Crutchfield Rd
Reidsville, NC 27320-8954
Phone (336) 613-1552

National Provider Directory

National Provider Directory
Tax ID family
Beverly Rucker Family Care Home 99 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477683084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 CRUTCHFIELD RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208954",
            "telephone_number": "336-613-1552",
            "fax_number": "336-349-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 FRANK RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273208699",
            "telephone_number": "336-613-1552",
            "fax_number": "336-349-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY RUCKER FAMILY CARE HOME #4",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "LAWSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "336-613-1552",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, 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.