Integrity Hermitage Retirement Center, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

HAL-077-012 Issued in NC

Legal business name

INTEGRITY HERMITAGE RETIREMENT CENTER, LLC

Doing business as

Hermitage Retirement Center

Practice address

139 Mallard LN
Rockingham, NC 28379-5203

Phone

(910) 895-0750

NPI assigned

Jun 21, 2017

Last updated

Nov 18, 2021By 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

Jonathan Swain Short

Title

Cio

Phone

(336) 438-1383

Specialties & licenses 1

Addresses

Other names 1

• Hermitage Retirement Center Doing business as

Locations

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1730609819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 KOGER BLVD STE 150",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274072738",
            "telephone_number": "336-438-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 MALLARD LN",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283795203",
            "telephone_number": "910-895-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY HERMITAGE RETIREMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "SWAIN",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "336-438-1383"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "HAL-077-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hermitage Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hermitage Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Rockingham, NC
• Providers in Rockingham, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.