Active NPI
Kellers Nursing Home Inc
- Adult Care Home Facility
- Sanford, NC
National Provider Identifier
1851405294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- HAL-053-001
- Legal business name
- KELLERS NURSING HOME INC
- Practice address
- 700 Westover Dr
Sanford, NC 27331-0640 - Phone
- (919) 775-1853
- Fax
- (919) 774-6482
- NPI assigned
- Aug 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda Keller Kelly, RN
- Title
- President
- Phone
- (919) 775-1853
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | HAL-053-001 | NC | Primary |
Addresses
Primary practice location
700 Westover Dr
Sanford, NC 27331-0640
Mailing address
PO Box 640
Sanford, NC 27331-0640
Phone (919) 775-1853
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7802023 | Medicaid | NC |
Other names 1
- Kellers Oakhaven Retirement Home
National Provider Directory
National Provider Directory- Tax ID family
- Kellers Nursing Home Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Care Home Facility
- Sanford, NC
- NPI 1205942067
-
- Adult Care Home Facility
- Sanford, NC
- NPI 1285743104
Locations
700 Westover Dr
Sanford, NC 27330
Phone (919) 775-1853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1851405294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "SANFORD",
"state": "NC",
"postal_code": "273310640",
"telephone_number": "919-775-1853",
"fax_number": "919-774-6482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 WESTOVER DR",
"city": "SANFORD",
"state": "NC",
"postal_code": "273310640",
"telephone_number": "919-775-1853",
"fax_number": "919-774-6482"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLERS NURSING HOME INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "KELLER",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "919-775-1853",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NC",
"license": "HAL-053-001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7802023",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kellers Oakhaven Retirement Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sanford, 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.