Eagle Peak LTC Group, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0037 Issued in NC

Legal business name

EAGLE PEAK LTC GROUP, LLC

Doing business as

Enfield Oaks Nursing and Rehabilitation Center

Practice address

208 Cary St
Enfield, NC 27823-1204

Phone

(252) 445-2111

Fax

(252) 445-5646

NPI assigned

Jun 25, 2006

Last updated

Mar 24, 2020By 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

Ms. Gale Boice

Title

Cfo

Phone

(252) 523-9094

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Enfield Oaks Nursing and Rehabilitation Center Doing business as

Tax ID family

Britthaven of Enfield2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Enfield Care, Inc.

  dba Britthaven of Enfield

  • Nursing Facility/Intermediate Care Facility
  • Enfield, NC
  • NPI 1326235755
  NPD tax ID

Locations

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1821024274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 HIGHWAY 258N",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285047208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CARY ST",
            "city": "ENFIELD",
            "state": "NC",
            "postal_code": "278231204",
            "telephone_number": "252-445-2111",
            "fax_number": "252-445-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE PEAK LTC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "BOICE",
        "authorized_official_first_name": "GALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "252-523-9094",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415101",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH PLAN",
            "identifier": "91-0085D",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NC",
            "identifier": "0085D",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425101",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416559",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enfield Oaks Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Enfield Oaks Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Enfield Care, Inc. (Britthaven of Enfield)
• Extra Home Health Care, Inc.
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• John Hume Faulkner, PA-C, MPH

• Skilled Nursing Facility in Enfield, NC
• Providers in Enfield, 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 Mar 24, 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.