RSS/Walnut Cove Operations, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

RSS/WALNUT COVE OPERATIONS, LLC

Doing business as

Walnut Ridge Assisted Living

Practice address

411 Windmill St
Walnut Cove, NC 27052-7705

Phone

(336) 891-9437

NPI assigned

Feb 23, 2022

Last updated

Apr 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennilee Richardson

Title

Chief Financial Officer

Phone

(919) 371-4233

Specialties & licenses 1

Addresses

Other names 1

• Walnut Ridge Assisted Living Doing business as

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1538815006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 WADE PARK BLVD STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074191",
            "telephone_number": "919-371-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WINDMILL ST",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270527705",
            "telephone_number": "336-891-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSS/WALNUT COVE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JENNILEE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "919-371-4233"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walnut Ridge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walnut Ridge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ridge Care Management, Inc.
• Amanda Lin Robertson
• Breanna Nicole Robertson, MS, LCAS-A
• Sandra Mitchell Robertson, PTA
• Olivia Caroline Roten, DMD
• Reinatou Sadou, LCMHCA
• Grant Shaffer
• Kelley Lynn Shannon, P.T.
• Kaci Shelton
• Amanda Gail Page Smith, LCSWA

• Adult Care Home Facility in Walnut Cove, NC
• Providers in Walnut Cove, 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 Apr 22, 2024; 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.