Louisburg Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0264 Issued in NC

Legal business name

LOUISBURG NURSING CENTER, INC.

Practice address

202 Smoketree Way
Louisburg, NC 27549-2165

Phone

(919) 496-2188

Fax

(919) 496-3364

NPI assigned

Feb 27, 2006

Last updated

Aug 22, 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

Mr. Nick Elledge

Title

Vice President

Phone

(336) 679-8852

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942276035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275490629",
            "telephone_number": "919-496-2188",
            "fax_number": "919-496-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SMOKETREE WAY",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492165",
            "telephone_number": "919-496-2188",
            "fax_number": "919-496-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISBURG NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLEDGE",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "336-679-8852",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO",
            "identifier": "0088G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406200",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405358",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisburg Hma Physician Management, LLC
• Louisburg Hospitalists, PLLC
• Louisburg Internal Medicine
• Louisburg Novant LLC (Novant Health Franklin Medical Center)
• Louisburg Novant, LLC (Novant Health Franklin Medical Center)
• Louisburg PPM LLC
• Louisburg Senior Village
• Sarah Georgieva Lukov, PT, DPT, CLT
• Roniecia Henderson Mack
• Casey Daniel Mackey, MSW

• Skilled Nursing Facility in Louisburg, NC
• Providers in Louisburg, 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 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.

Verify at the official NPI Registry.