ALTA WALK ASSISTED LIVING (NPI# 1801124979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801124979 |
| Entity Type | Organization |
| Organization Name | ALTA WALK ASSISTED LIVING |
| Practice Address |
5705 Fayetteville Rd Durham NC 27713-5318 |
| Practice Telephone | 9194010100 |
| Practice Fax Number | 9195448402 |
| Mailing Telephone | 9194010100 |
| Mailing Fax Number | 9195448402 |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |
| Authorized Official Name | MR. KATHLEEN ELIZABETH VIDAL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9194010100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | HAL032094 | NC | Nursing & Custodial Care Facilities |
| Street Address |
5705 FAYETTEVILLE RD |
| City | DURHAM |
| State | NC |
| Zip Code | 27713-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235753302 | Allison Wethey | Occupational Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2020-06-03 |
| 1275009698 | Jessica Ridenhour King | Occupational Therapy Assistant | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2018-10-23 |
| 1003339961 | Michelle Baumgart | Physical Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2017-07-24 |
| 1356882591 | Jamie Stiller | Occupational Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2017-03-20 |
| 1023554375 | Richard Greer | Physical Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2017-01-10 |
| 1811432917 | Stephanie Worrell | Occupational Therapy Assistant | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2016-12-27 |
| 1851798516 | Rebecca Ann Ward | Physical Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2014-11-24 |
| 1659702470 | Anita M Keith | Physical Therapy Assistant | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2013-12-04 |
| 1528304540 | Christine Elizabeth Herzog | Physical Therapist | 5705 Fayetteville Rd, Durham, NC 27713-5318 | 2012-12-19 |
| 1811259880 | Tasha Lasanya Gettys | Occupational Therapy Assistant | 5705 Fayetteville Rd, Durham, NC 27713 | 2012-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1205486081 | Lisa Mesmer Barnes | Nurse Practitioner | 5309hwy 55, Suite 105, Durham, NC 27713 | 2019-09-13 |
| 1497315352 | Mary Therese Wood | Social Worker | 1822 E Highway 54, Suite 300, Durham, NC 27713 | 2019-06-13 |
| 1720558307 | Kevin D Simmons | Counselor | 1822 Nc Hwy 54 Suite 300, Durham, NC 27713 | 2018-11-27 |
| 1790265585 | Kelli Cryer | Counselor | 54 E Nc Hwy 1822, Suite 300, Durham, NC 27713 | 2018-08-21 |
| 1477039253 | Mahavir Rx, LLC | Pharmacy | 6216 Fayetteville Rd Ste 105, Durham, NC 27713 | 2018-07-16 |
| 1811482862 | Tessa Taylor | Dentist | 2515 E Nc Highway 54 Ste 2000, Durham, NC 27713 | 2018-06-22 |
| 1013401579 | Emily Louise Haller | Counselor | 1822 E Hwy 54, Suite 300, Durham, NC 27713 | 2018-06-19 |
| Find all providers in zip 27713 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366958233 | August Estates LLC | Assisted Living Facility | 2713 Green Lane Dr, Durham, NC 27712-2432 | 2017-12-14 |
| 1922360684 | Carillon Assisted Living of Durham | Assisted Living Facility | 4713 Garrett Rd, Durham, NC 27707-3439 | 2012-06-08 |
| 1588948707 | Emeritus Corporation | Assisted Living Facility | 25 Worthen Rd, Durham, NH 03824-4612 | 2011-10-06 |
| 1669754693 | Ruffin Home 2 | Assisted Living Facility | 830 N. Mangum St., Durham, NC 27701 | 2011-09-15 |
| 1265720825 | Snh Se Tenant Trs, Inc | Assisted Living Facility | 1002 E Nc Highway 54, Durham, NC 27713-2145 | 2011-07-18 |
| 1922322056 | Ramsgate Family Care Home, LLC | Assisted Living Facility | 3676 Guess Rd, Durham, NC 27705-2112 | 2010-03-18 |
| 1184856064 | A New Way Home | Assisted Living Facility | 510 Maymount Dr, Durham, NC 27703-3657 | 2009-08-11 |
| 1518112036 | Pruitthealth - Carolina Point, LLC | Assisted Living Facility | 5935 Mount Sinai Road, Durham, NC 27705-8616 | 2008-11-25 |
| 1881847366 | Avail Family Care Homes LLC | Assisted Living Facility | 1008 N Guthrie Ave, Durham, NC 27703-1620 | 2008-10-29 |
| 1366695819 | Avail Family Care Homes LLC | Assisted Living Facility | 1012 N Guthrie Ave, Durham, NC 27703-1620 | 2008-10-28 |
| Find all providers in DURHAM | ||||
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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.