NPIMap

Organization Active NPI

Carolinas Anson Healthcare, Inc.

Doing business as Lillie Bennett Nursing Center

  • Skilled Nursing Facility
  • Wadesboro, NC
National Provider Identifier
1619963832
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
H0082 Issued in NC
Legal business name
CAROLINAS ANSON HEALTHCARE, INC.
Doing business as
Lillie Bennett Nursing Center
Practice address
500 Morven Rd
Wadesboro, NC 28170-2745
Phone
(704) 694-5131
Fax
(704) 694-3900
NPI assigned
Sep 22, 2005
Last updated
Sep 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Mr. John G Moore
Title
Cfo
Phone
(704) 694-5131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X H0082 NC Primary

Addresses

Primary practice location

500 Morven Rd
Wadesboro, NC 28170-2745

Mailing address

500 Morven Rd
Wadesboro, NC 28170-2745
Phone (704) 694-5131

Other identifiers 3

IdentifierTypeStateIssuer
3415051MedicaidNC
3416531MedicaidNC
1315600001OtherNCDURABLE MEDICAL EQUIPMENT

Other names 1

  • Lillie Bennett Nursing Center Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1619963832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MORVEN RD",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702745",
            "telephone_number": "704-694-5131",
            "fax_number": "704-694-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MORVEN RD",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281702745",
            "telephone_number": "704-694-5131",
            "fax_number": "704-694-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS ANSON HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "704-694-5131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "H0082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415051",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416531",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT",
            "identifier": "1315600001",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lillie Bennett Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wadesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.