NPIMap

Organization Active NPI

Creekside Opco LLC

Doing business as The Cambridge

  • Assisted Living Facility
  • Smyrna, GA
National Provider Identifier
1669132304
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
CREEKSIDE OPCO LLC
Doing business as
The Cambridge
Practice address
4838 S Cobb Dr SE
Smyrna, GA 30080-7121
Phone
(678) 903-0339
NPI assigned
Dec 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Mr. Charles E Trefzger Jr.
Title
Manager
Phone
(828) 322-5535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4838 S Cobb Dr SE
Smyrna, GA 30080-7121

Mailing address

PO Box 2568
Hickory, NC 28603-2568
Phone (828) 322-5535

Other names 1

  • The Cambridge Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1669132304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-322-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807121",
            "telephone_number": "678-903-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Cambridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.