Canton Christian Convalescent Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0081 Issued in NC

Legal business name

CANTON CHRISTIAN CONVALESCENT CENTER, LLC

Doing business as

Maggie Valley Nursing and Rehabilitation

Practice address

75 Fisher Loop
Maggie Valley, NC 28751-5531

Phone

(828) 566-3002

Fax

(828) 648-0201

NPI assigned

Sep 23, 2005

Last updated

Nov 8, 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

Mr. Charles E Trefzger Jr.

Title

Manager

Phone

(828) 322-5535

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Maggie Valley Nursing and Rehabilitation Doing business as

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1730175985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FISHER LOOP",
            "city": "MAGGIE VALLEY",
            "state": "NC",
            "postal_code": "287515531",
            "telephone_number": "828-566-3002",
            "fax_number": "828-648-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FISHER LOOP",
            "city": "MAGGIE VALLEY",
            "state": "NC",
            "postal_code": "287515531",
            "telephone_number": "828-566-3002",
            "fax_number": "828-648-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON CHRISTIAN CONVALESCENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3435358",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3445102",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maggie Valley Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tammy Gail Backlund, PTA
• Abigail Bentzel, MS, BCBA
• Barbara Carroll, OTR/L
• Cmrhc, Inc. (B&C Pharmacy)
• Barbara D. Cole, MS; MA
• Current Dermatology
• Jeanie K Deaver

• Skilled Nursing Facility in Maggie Valley, NC
• Providers in Maggie Valley, 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 Nov 8, 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.