Mountain Trace Nursing Adk, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0623 Issued in NC

Legal business name

MOUNTAIN TRACE NURSING ADK, LLC

Practice address

417 Mountain Trace Rd
Sylva, NC 28779-6779

Phone

(828) 631-1600

Fax

(828) 631-1648

NPI assigned

Jan 4, 2011

Organization subpart

No

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

Authorized official

Name

Carol Groeber

Title

Vice President/Mis

Phone

(937) 964-8974

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mountain Trace Rehabilitation and Nursing Center Doing business as

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1982908083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MOUNTAIN TRACE RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287796779",
            "telephone_number": "828-631-1600",
            "fax_number": "828-631-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MOUNTAIN TRACE RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287796779",
            "telephone_number": "828-631-1600",
            "fax_number": "828-631-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN TRACE NURSING ADK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "GROEBER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VICE PRESIDENT/MIS",
        "authorized_official_telephone_number": "937-964-8974"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415302",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Trace Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mountain Park Urgent Care & Walk-in Clinic, PLLC
• Mountain Pathology Services PA
• Mountain Soul Counseling, PLLC
• Mountain Surgical Associates
• Mountain Trace Enterprise LLC
• Mountain View Physicians
• Mountain View Physicians
• Mountain Youth Resources, Inc.
• Mountaincare Urology
• Mountaineer Oxygen Services

• Skilled Nursing Facility in Sylva, NC
• Providers in Sylva, 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 Jan 28, 2011; 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.