NPIMap

Organization Active NPI

RV Nursing Home, LLC

Doing business as Rich Square Villa

  • Assisted Living Facility
  • Rich Square, NC
National Provider Identifier
1649348707
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL-066-010 Issued in NC
Legal business name
RV NURSING HOME, LLC
Doing business as
Rich Square Villa
Practice address
310 North Main Street
Rich Square, NC 27869-0560
Phone
(252) 539-2011
Fax
(252) 539-2317
NPI assigned
Nov 30, 2006
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
RV NURSING HOME LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Mr. James T Johnson Jr.
Title
Owner
Phone
(252) 209-6834

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL-066-010 NC Primary

Addresses

Primary practice location

310 North Main Street
Rich Square, NC 27869-0560

Mailing address

310 North Main Street
P O Box 560
Rich Square, NC 27869-0560
Phone (252) 539-2011

Other names 1

  • Rich Square Villa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
RV Nursing Home LLC2 organizations share this tax ID, including this one
Part of
RV Nursing Home LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1649348707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NORTH MAIN STREET",
            "address_2": "P O BOX 560",
            "city": "RICH SQUARE",
            "state": "NC",
            "postal_code": "278690560",
            "telephone_number": "252-539-2011",
            "fax_number": "252-539-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NORTH MAIN STREET",
            "city": "RICH SQUARE",
            "state": "NC",
            "postal_code": "278690560",
            "telephone_number": "252-539-2011",
            "fax_number": "252-539-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RV NURSING HOME, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RV NURSING HOME LLC",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-209-6834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-066-010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rich Square Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rich Square, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; 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.