NPIMap

Organization Active NPI

Harris Enterprises of NC, Inc

Doing business as Doing Business As: St Mark's Road Care Home

  • Assisted Living Facility
  • Crouse, NC
National Provider Identifier
1497812119
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HCL-036-024 Issued in NC
Legal business name
HARRIS ENTERPRISES OF NC, INC
Doing business as
Doing Business As: St Mark's Road Care Home
Practice address
1230 St Mark's Road Care Home
Crouse, NC 28033
Phone
(704) 460-4072
Fax
(704) 484-3098
NPI assigned
Jan 2, 2007
Last updated
Oct 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Authorized official

Name
Georgette Harris JohnsonNPI 1902344666
Title
President
Phone
(704) 460-4072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HCL-036-024 NC Primary

Addresses

Primary practice location

1230 St Mark's Road Care Home
Crouse, NC 28033

Mailing address

PO Box 1803
Shelby, NC 28151-1803
Phone (704) 460-4072

Other names 1

  • Doing Business As: St Mark's Road Care Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doing Business As St Mark's Road Care Home5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1497812119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1803",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281511803",
            "telephone_number": "704-460-4072",
            "fax_number": "704-484-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 ST MARK'S ROAD CARE HOME",
            "city": "CROUSE",
            "state": "NC",
            "postal_code": "28033",
            "telephone_number": "704-460-4072",
            "fax_number": "704-484-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS ENTERPRISES OF NC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GEORGETTE",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-460-4072"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HCL-036-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doing Business As: St Mark's Road Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crouse, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.