Country Pines Family Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FCL 012017 Issued in NC

Legal business name

COUNTRY PINES FAMILY CARE HOME

Doing business as

Country Pines II

Practice address

3041 Country Pines St
Morganton, NC 28655-0122

Phone

(828) 438-2886

Fax

(828) 334-3439

NPI assigned

Apr 10, 2007

Last updated

Mar 4, 2024By 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

Mrs. Shirley J. CarswellNPI 1164554234

Title

Administrator

Phone

(828) 438-2886

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Country Pines II Doing business as

Tax ID family

Country Pines Adult Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shirley J Carswell

  dba Country Pines Adult Care Home

  • Assisted Living Facility
  • Morganton, NC
  • NPI 1669594198
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shirley Jean Carswell

  • Assisted Living Facility
  • Morganton, NC
  • NPI 1164554234
  NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1952424152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 ROB CARSWELL ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286559438",
            "telephone_number": "828-438-2886",
            "fax_number": "828-437-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 COUNTRY PINES ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286550122",
            "telephone_number": "828-438-2886",
            "fax_number": "828-334-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY PINES FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "CARSWELL",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-438-2886",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL 012017",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7802855",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Pines II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cora's House LLC
• Cordium Links, LLC
• Malcolm O Corley, MD
• Donald Joseph Costic, M.D.
• Country Pines 1
• County of Burke (Burke County Department of Social Services)
• County of Burke (Burke County Health Dept-Clinic Service)
• County of Burke (Burke County EMS)
• County of Burke (Burke County Health Dept-BH)
• County of Burke (DBA Burke County Health Department)

• Assisted Living Facility in Morganton, NC
• Providers in Morganton, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.