NPIMap

Organization Active NPI

Sovereign Healthcare,LLC

  • Assisted Living Facility
  • Washington, NC
National Provider Identifier
1902921844
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
FCL025022 Issued in NC
Legal business name
SOVEREIGN HEALTHCARE,LLC
Practice address
114 Hodges Ave
Washington, NC 27889-3855
Phone
(252) 946-4334
Fax
(252) 946-9334
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Dianna Renee Turner
Title
Administrator
Phone
(252) 946-4334

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X HAL007014 NC
Assisted Living Facility 310400000X HAL072008 NC
Assisted Living Facility 310400000X HAL025023 NC
Assisted Living Facility 310400000X FCL025022 NC Primary
Assisted Living Facility 310400000X HAL007015 NC
Assisted Living Facility 310400000X HAL008017 NC
Assisted Living Facility 310400000X HAL007007 NC
Assisted Living Facility 310400000X HAL074026 NC
Assisted Living Facility 310400000X HAL 008-033 NC

Addresses

Primary practice location

114 Hodges Ave
Washington, NC 27889-3855

Mailing address

114 Hodges Ave
Washington, NC 27889-3855
Phone (252) 946-4334

Other identifiers 5

IdentifierTypeStateIssuer
7805577MedicaidNC
7805167MedicaidNC
7805165MedicaidNC
7805163MedicaidNC
7805164MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sovereign Healthcarellc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1902921844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HODGES AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893855",
            "telephone_number": "252-946-4334",
            "fax_number": "252-946-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HODGES AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893855",
            "telephone_number": "252-946-4334",
            "fax_number": "252-946-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTHCARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-946-4334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL007014",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL072008",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL025023",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL025022",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL007015",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL008017",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL007007",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL074026",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL 008-033",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805577",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805167",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805165",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805163",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805164",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.