Organization Active NPI

Pine Gardens Adult Care

  • Assisted Living Facility
  • Oxford, NC
National Provider Identifier
1710102843
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
HAL-039-004 Issued in NC
Legal business name
PINE GARDENS ADULT CARE
Practice address
6016 Pinetown Rd
Oxford, NC 27565-7955
Phone
(919) 693-2984
Fax
(919) 603-0287
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Joyce A Harris
Title
Adminstrator
Phone
(919) 693-2984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL-039-004 NC Primary

Addresses

Primary practice location

6016 Pinetown Rd
Oxford, NC 27565-7955

Mailing address

6016 Pinetown Rd
Oxford, NC 27565-7955
Phone (919) 693-2984

Other identifiers 1

IdentifierTypeStateIssuer
7802157MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710102843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 PINETOWN RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275657955",
            "telephone_number": "919-693-2984",
            "fax_number": "919-603-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6016 PINETOWN RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275657955",
            "telephone_number": "919-693-2984",
            "fax_number": "919-603-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GARDENS ADULT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "919-693-2984",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-039-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802157",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, NC

Sources for this page

  • 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.