Davis Rest Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-041-007 Issued in NC

Legal business name

DAVIS REST HOME

Practice address

1514 Woodbriar Ave
Greensboro, NC 27405-5366

Phone

(336) 375-4400

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Bettie Davis

Title

Owner

Phone

(336) 275-0627

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Davis Rest Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Davis Rest Home

  • Adult Care Home Facility
  • Greensboro, NC
  • NPI 1588793814
  NPD tax ID

Locations

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1487784542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36448",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274166448",
            "telephone_number": "336-275-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 WOODBRIAR AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055366",
            "telephone_number": "336-375-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BETTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-275-0627",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-041-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801495",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Davidowitz, OTR/L
• Courtney Jane Davidson, PT
• John Carl Davidson Jr., DPT,MOTR
• Tyanna Davidson
• Rachel Marie Davila, DO
• Davis Rest Home
• Emma Christine Davis-Potter, RN
• Zolee Viel Davis-Robinson, PHD
• Alexis Davis, LCSWA
• Alice Wade Davis, PASTORAL COUNSELOR

• Adult Care Home Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.