TD Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

TD CARE HOME

Practice address

523 E Marion St
Shelby, NC 28150-4615

Phone

(980) 552-9651

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Donnie Vaughn Puett

Title

Member/ Manager

Phone

(828) 443-7792

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1962238907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 E MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504615",
            "telephone_number": "980-552-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504615",
            "telephone_number": "980-552-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TD CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "PUETT",
        "authorized_official_first_name": "DONNIE",
        "authorized_official_middle_name": "VAUGHN",
        "authorized_official_title_or_position": "MEMBER/ MANAGER",
        "authorized_official_telephone_number": "828-443-7792"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.