Crescent Green of Carrboro, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-068-024 Issued in NC

Legal business name

CRESCENT GREEN OF CARRBORO, INC

Practice address

624 Jones Ferry Road
Carrboro, NC 27510

Phone

(919) 933-9570

Fax

(919) 933-9572

NPI assigned

Feb 15, 2007

Last updated

Aug 25, 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

Sherri L Everett

Title

Business Office Manager

Phone

(919) 933-9570

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1932242252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 JONES FERRY ROAD",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "27510",
            "telephone_number": "919-933-9570",
            "fax_number": "919-933-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 JONES FERRY ROAD",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "27510",
            "telephone_number": "919-933-9570",
            "fax_number": "919-933-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT GREEN OF CARRBORO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "919-933-9570"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-068-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805622",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.