Nubbing Hill Healthcare, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-026-046 Issued in NC

Legal business name

NUBBING HILL HEALTHCARE, INC.

Doing business as

Countryside Villa

Practice address

8100 Dunn Road
Wade, NC 28395

Phone

(910) 980-1275

Fax

(910) 980-1118

NPI assigned

Sep 21, 2006

Last updated

Aug 22, 2020By 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

Mr. John A. Weeks

Title

Owner/Administrator

Phone

(910) 980-1275

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Countryside Villa Doing business as

Tax ID family

Countryside Villa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Nubbing Hill Healthcare, Inc.

  dba Eastover Gardens

  • Alzheimer Center (Dementia Center)
  • Eastover, NC
  • NPI 1669613006
  NPD tax ID

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689772501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "WADE",
            "state": "NC",
            "postal_code": "283950309",
            "telephone_number": "910-980-1275",
            "fax_number": "910-980-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 DUNN ROAD",
            "city": "WADE",
            "state": "NC",
            "postal_code": "28395",
            "telephone_number": "910-980-1275",
            "fax_number": "910-980-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUBBING HILL HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "910-980-1275",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-026-046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804901",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Countryside Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Bennett Hudson, PA-C
• Patti Jordan, LCSW
• Denise K. Lowe, EDD
• James Maxwell, MD
• Amy D McLaurin, PTA
• Abimbola Bridget Olaore, RN
• Crystal Pone, LCSWA
• Stedman-Wade Health Services, Inc.
• Stedman-Wade Health Services, Inc.
• Sabrina J Weber

• Assisted Living Facility in Wade, NC
• Providers in Wade, 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 Aug 22, 2020; 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.