MILDRED BLACKWELL (NPI# 1164542882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164542882 |
| Entity Type | Organization |
| Organization Name | MILDRED BLACKWELL |
| Other Organization Name | DOGWOOD FOREST NO. TWO |
| Practice Address |
3658 Cherry Grove Rd Elon NC 27244-9483 |
| Mailing Address |
203 N Main St Suite 315 Roxboro NC 27573-5343 |
| Practice Telephone | 3364210646 |
| Mailing Telephone | 3364210646 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MILDRED BLACKWELL (OWNER) |
| Authorized Official Telephone | 3364210646 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
HAL017003 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7801723 | 05 |
| Other Name | Type Code |
|---|---|
| Dogwood Forest No. Two | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992025316 | Mildred Blackwell | Custodial Care Facility | 3592 Marshall Graves Rd, Yanceyville, NC 27379-8630 | 2010-06-08 |
| Street Address |
3658 CHERRY GROVE RD |
| City | ELON |
| State | NC |
| Zip Code | 27244-9483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144702846 | Eric Roman | Specialist/Technologist | Koury Field House 2500 Campus Box, Elon, NC 27244 | 2018-08-30 |
| 1457845489 | Hannah Daly | Specialist/Technologist | 104 E. Haggard Avenue, Elon, NC 27244 | 2018-06-22 |
| 1780113068 | Ewa W Czajkowska-jenkins | Physical Therapist | 106 Palladium Ct, Elon, NC 27244 | 2017-06-08 |
| 1003294059 | Adriana Cline | Pediatrics | 908 South Williamson Avenue, Elon, NC 27244 | 2015-05-11 |
| 1568859288 | Michelle Smith Flinchum | Nurse Practitioner | 301 O' Kelly Avenue, Elon, NC 27244 | 2015-04-21 |
| 1861890139 | Emily Williams | Specialist/Technologist | 301 S. O'kelly Ave, Elon, NC 27244 | 2014-12-18 |
| 1891100988 | Sarah Parker | Nurse Practitioner | 301 South O'kelly Avenue, Rn Ellington Center for Health and Wellness, Elon, NC 27244 | 2014-06-26 |
| 1194937698 | Robert Andrew Watson | General Practice | 311 Truitt Drive, Elon, NC 27244 | 2007-05-04 |
| 1487773909 | Robert Norwood Ellington | Obstetrics & Gynecology | 100 Campus Dr, 2040 Campus Box, Elon, NC 27244 | 2007-03-28 |
| 1164540225 | Elon Village Homes, Inc. | Assisted Living Facility | 715 E Haggard Ave., Elon, NC 27244 | 2007-03-27 |
| Find all providers in zip 27244 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275968679 | Humphrey Family Care Home | Custodial Care Facility | 3814 Cherry Grove Rd, Elon, NC 27244-9485 | 2013-09-05 |
| 1629151097 | Parkers Family Care Home | Custodial Care Facility | 502 Westgate Dr, Elon, NC 27244-9271 | 2006-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.