Coventry House of Zebulon

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-092-115 Issued in NC

Legal business name

COVENTRY HOUSE OF ZEBULON

Practice address

1225 W Gannon Ave
Zebulon, NC 27597-8838

Phone

(919) 269-7762

NPI assigned

Jan 5, 2007

Last updated

Jan 2, 2008By 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

Mrs. Ravonda Tart

Title

Executive Director

Phone

(919) 269-7762

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1689722944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W GANNON AVE",
            "address_2": "PO BOX 888",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275978838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W GANNON AVE",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275978838",
            "telephone_number": "919-269-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENTRY HOUSE OF ZEBULON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "TART",
        "authorized_official_first_name": "RAVONDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-269-7762",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-092-115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "7805473",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Zebulon, NC
• Providers in Zebulon, 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 Jan 2, 2008; 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.