Valdese Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0553 Issued in NC

Legal business name

VALDESE NURSING HOME INC

Doing business as

Colleg Pines Health & Rehab Center

Practice address

95 Locust St
Connelly Springs, NC 28612-8007

Phone

(828) 580-6800

Fax

(828) 580-6803

NPI assigned

Oct 11, 2005

Last updated

Oct 13, 2011By 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

Robert Fritts

Title

Senior Vice President Cfo

Phone

(828) 580-5545

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Colleg Pines Health & Rehab Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Primary Care and Integrative Medicine

  • Internal Medicine Physician
  • Concord, NC
  • NPI 1023445517

  Member Of

  NPD member

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1699763904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "VALDESE",
            "state": "NC",
            "postal_code": "286900250",
            "telephone_number": "828-580-6800",
            "fax_number": "828-580-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LOCUST ST",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128007",
            "telephone_number": "828-580-6800",
            "fax_number": "828-580-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDESE NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "FRITTS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "828-580-5545"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NUMBER",
            "identifier": "923110",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC PROVIDER",
            "identifier": "0090P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405446",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340606A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colleg Pines Health & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy J Stilwell, MPT
• The Speech Wagon PLLC
• Triad Orthotics & Prosthetics
• Kristina Cree Triplett, FNP-C
• Valdese Nursing Home (College Pines Health and Rehabilitation Center)
• Gloria Marie Vodan, CNM, MSN
• Walgreen Co (Walgreens #15351)
• Richard Dean Wall, PHARM.D.
• Traci Myers White, NP-C
• Joseph Young

• Skilled Nursing Facility in Connelly Springs, NC
• Providers in Connelly Springs, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.