NPIMap

Organization Active NPI

Morningside of Concord LLC

Doing business as Fox Hollow Senior Living Community

  • Assisted Living Facility
  • Pinehurst, NC
National Provider Identifier
1689726507
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL-063-022 Issued in NC
Legal business name
MORNINGSIDE OF CONCORD LLC
Doing business as
Fox Hollow Senior Living Community
Practice address
190 Fox Hollow Road
Pinehurst, NC 28374
Phone
(910) 695-0011
Fax
(910) 695-1147
NPI assigned
Jan 18, 2007
Last updated
Jun 23, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MORNINGSIDE OF CONCORD LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Katherine E. Potter
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL-063-022 NC Primary

Addresses

Primary practice location

190 Fox Hollow Road
Pinehurst, NC 28374

Mailing address

400 Centre St
Newton, MA 02458-2094
Phone (617) 796-8387

Other identifiers 1

IdentifierTypeStateIssuer
7806152MedicaidNC

Other names 1

  • Fox Hollow Senior Living Community Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1009870Charter Senior Living of Fox Hollow190 Fox Hollow, Pinehurst, NC 28374Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Five Star Quality Care9 organizations share this tax ID, including this one
Part of
Morningside of Concord LLC

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1689726507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024582094",
            "telephone_number": "617-796-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 FOX HOLLOW ROAD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-695-0011",
            "fax_number": "910-695-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORNINGSIDE OF CONCORD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MORNINGSIDE OF CONCORD LLC",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-063-022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7806152",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Hollow Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fox Hollow Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.