Carillon Assisted Living of Knightdale, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CARILLON ASSISTED LIVING OF KNIGHTDALE, LLC

Practice address

2408 Hodge Rd
Knightdale, NC 27545-9386

Phone

(919) 852-4000

Fax

(919) 852-4001

NPI assigned

Jan 4, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Mark Johnson

Title

Chief Financial Officer

Phone

(919) 852-4000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1699079715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 WATERS EDGE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062464",
            "telephone_number": "919-852-4000",
            "fax_number": "919-852-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 HODGE RD",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275459386",
            "telephone_number": "919-852-4000",
            "fax_number": "919-852-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARILLON ASSISTED LIVING OF KNIGHTDALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "919-852-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.