Highland House of Fayetteville, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0117 Issued in NC

Legal business name

HIGHLAND HOUSE OF FAYETTEVILLE, INC

Practice address

1700 Pamalee Dr
Fayetteville, NC 28301-2824

Phone

(910) 488-2295

Fax

(910) 488-0087

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Edward Eller

Title

Controller

Phone

(336) 998-5001

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Highland House Rehabilitation & Healthcare Other name

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1699886085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012824",
            "telephone_number": "910-488-2295",
            "fax_number": "910-488-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012824",
            "telephone_number": "910-488-2295",
            "fax_number": "910-488-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND HOUSE OF FAYETTEVILLE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "336-998-5001"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405353",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406055",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801640",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland House Rehabilitation & Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Skilled Nursing Facility in Fayetteville, NC
• Providers in Fayetteville, 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 Dec 13, 2012; 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.