Estella Joann Spann

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

017058 Issued in NC

Practice address

1136 Bertha Wilson Rd
Blanch, NC 27212-9795

Phone

(336) 694-1878

Fax

(336) 694-1878

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Taylor Family Care 2 LLC

  • Assisted Living Facility
  • Blanch, NC
  • NPI 1780338566
  NPD Authorized official

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1639823784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 BERTHA WILSON RD",
            "city": "BLANCH",
            "state": "NC",
            "postal_code": "272129795",
            "telephone_number": "336-694-1878",
            "fax_number": "336-694-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 BERTHA WILSON RD",
            "city": "BLANCH",
            "state": "NC",
            "postal_code": "272129795",
            "telephone_number": "336-694-1878",
            "fax_number": "336-694-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "ESTELLA",
        "middle_name": "JOANN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NM",
            "license": "017058",
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NC",
            "license": "017058",
            "primary": false
        },
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NC",
            "license": "017058",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "017058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE  NUMBER",
            "identifier": "017058",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tifany Chambers, BSW, QP, CPSS
• Empowering U, LLC
• Lois Ann Knauff, DDS
• Mitchell Family Care Home
• Sisters Living Services, LLC
• Taylor Care Group, LLC
• Taylor Family Care 2 LLC
• Barbara Lee Taylor, DPM
• Stefano Vitale, D.O.M., L.AC.

• Assisted Living Facility in Blanch, NC
• Providers in Blanch, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.