NPIMap

Organization Active NPI

Chestnut Manor Mangum Street

  • Assisted Living Facility
  • Durham, NC
National Provider Identifier
1699914283
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
FCL-032-092 Issued in NC
Legal business name
CHESTNUT MANOR MANGUM STREET
Practice address
830 N Mangum St
Durham, NC 27701-2259
Phone
(919) 688-6923
NPI assigned
Feb 5, 2009
Organization subpart
Yes
Parent organization
CHESTNUT MANOR INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Mrs. Yolanda Chestnut Jackson
Title
Administrator
Phone
(919) 638-6174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X FCL-032-092 NC Primary

Addresses

Primary practice location

830 N Mangum St
Durham, NC 27701-2259

Mailing address

830 N Mangum St
Durham, NC 27701-2259
Phone (919) 688-6923

Other names 1

  • chestnut manor Other name

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Manor-Forest Hill2 organizations share this tax ID, including this one
Part of
Chestnut Manor-Forest Hill

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1699914283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N MANGUM ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277012259",
            "telephone_number": "919-688-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N MANGUM ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277012259",
            "telephone_number": "919-688-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT MANOR MANGUM STREET",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESTNUT MANOR INC.",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "CHESTNUT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-638-6174",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL-032-092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "chestnut manor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.