Camelot Manor Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-014-014 Issued in NC

Legal business name

CAMELOT MANOR INC

Doing business as

DBA Brockford Inn Inc

Practice address

56 N Highland Ave
Dba Brockford Inn Inc
Granite Falls, NC 28630-1205

Phone

(828) 396-3111

Fax

(828) 396-5822

NPI assigned

Sep 25, 2006

Last updated

Jul 15, 2008By 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

Mrs. Judith Barlow

Title

Administrator/ Owner

Phone

(828) 396-3111

Specialties & licenses 2

Addresses

Other names 1

• DBA Brockford Inn Inc Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1720188915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58",
            "address_2": "DBA BROCKFORD INN INC",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286300058",
            "telephone_number": "828-396-3111",
            "fax_number": "828-396-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 N HIGHLAND AVE",
            "address_2": "DBA BROCKFORD INN INC",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286301205",
            "telephone_number": "828-396-3111",
            "fax_number": "828-396-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "ADMINISTRATOR/ OWNER",
        "authorized_official_telephone_number": "828-396-3111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-014-014",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NC",
            "license": "HAL-014-014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Brockford Inn Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caldwell Memorial Hospital, Inc (The Falls Pediatrics)
• Caldwell Memorial Hospital, Inc (The Falls Medical Park)
• Caldwell Memorial Hospital, Inc. (The Falls Neurology and Memory Center)
• Elizabeth Caldwell
• Wendy Calloway
• Camelot Manor Nursing Care Facility Inc
• Camelot Manor Nursing Care Facility, Inc
• Anne Luckadoo Cannon, MSW
• Catawba Valley Resource LLC (Catawba Valley Resource Interventions and Consulting)
• Annette Chontos

• Assisted Living Facility in Granite Falls, NC
• Providers in Granite Falls, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.