Bear Creek Manor II

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-061-002 Issued in NC

Legal business name

BEAR CREEK MANOR II

Practice address

1501 Bear Creek Rd
Bakersville, NC 28705-8509

Phone

(828) 688-3807

Fax

(828) 688-9407

NPI assigned

Mar 29, 2007

Last updated

Jun 13, 2008By 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

Charles Troy Burke

Title

Administrator

Phone

(828) 688-3807

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1942320759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 BEAR CREEK RD",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287058509",
            "telephone_number": "828-688-3807",
            "fax_number": "828-688-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BEAR CREEK RD",
            "city": "BAKERSVILLE",
            "state": "NC",
            "postal_code": "287058509",
            "telephone_number": "828-688-3807",
            "fax_number": "828-688-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CREEK MANOR II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-688-3807"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-061-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Bakersville, NC
• Providers in Bakersville, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.