Kerner Ridge Assisted Living LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

KERNER RIDGE ASSISTED LIVING LLC

Practice address

250 Hopkins Rd
Kernersville, NC 27284-9314

Phone

(336) 993-1881

NPI assigned

Mar 9, 2007

Last updated

Oct 12, 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

Cynthia Ann Neagle

Title

VP Finance

Phone

(336) 993-7555

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1972634905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 OLD WINSTON RD STE 118",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848781",
            "telephone_number": "336-993-7555",
            "fax_number": "336-993-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOPKINS RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272849314",
            "telephone_number": "336-993-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERNER RIDGE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "NEAGLE",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "336-993-7555"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804126",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Sherwood Kelly, R.D.
• William Sherwood Kelly, M.D.
• Jessica Holder Kendall, PT, DPT
• Rachael Kennedy, PHARMD
• Levi Alan Kerby, PT DPT
• Kernersville Chiropractic Center
• Kernersville Counseling Center PLLC
• Kernersville Emergency Group, PLLC
• Kernersville Eye Associates, O.D., P.a.
• Kernersville Eye Surgeons, PC

• Adult Care Home Facility in Kernersville, NC
• Providers in Kernersville, 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 Oct 12, 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.