FAYETTEVILLE MANOR, LLC
NPI 1255571766
Assisted Living Facility in Fayetteville, NC
NPI Status: Active since February 23, 2009
Contact Information
231 TREETOP DR
FAYETTEVILLE, NC
ZIP 28311
Phone: (910) 488-4821
Fax: (910) 488-5069
- Organization
- Assisted Living Facility
- CLIA Number: 34D2207904
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 12-30-2026
About FAYETTEVILLE MANOR, LLC
This page provides the complete NPI Profile along with additional information for Fayetteville Manor, Llc, a provider established in Fayetteville, North Carolina operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1255571766 assigned on February 2009. The practitioner's primary taxonomy code is 310400000X with license number HAL-026-054 (NC). The provider is registered as an organization and their NPI record was last updated 16 years ago. The authorized official of this NPI record is Mr. Thomas Husvar (Member)
- NPI
- 1255571766
- Provider Name
- FAYETTEVILLE MANOR, LLC
- Entity Type
- Organization
- Location Address
- 231 TREETOP DR FAYETTEVILLE, NC 28311
- Location Phone
- (910) 488-4821
- Location Fax
- (910) 488-5069
- Mailing Address
- PO BOX 9895 FAYETTEVILLE, NC 28311
- Mailing Phone
- (910) 488-4821
- Mailing Fax
- (910) 488-5069
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-23-2009
- Last Update Date
- 02-23-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- HAL-026-054
- License State
- NC
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2207904
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- December 31, 2024
- Certificate Expiration Date
- December 30, 2026
- Laboratory Director
- TORREY LOCKLEAR
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fayetteville Manor, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 5 | 5 | 5 | 7 | 1 | 7 | 6 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 10 | 5 | 10 | 7 | 2 | 7 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 0 + 5 + 1 + 0 + 7 + 2 + 7 + 1 + 2 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1255571766 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 16 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1831575224 | MADILYN SMITH PTA Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1912373341 | KA-RON DAWN HAUMANN Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-9008 |
| 1114394178 | INGRID ARCE Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1366961559 | KIMBERLY NICOLE JOYCE PTA Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1639669500 | AUDREY ROSE PAGTALUNAN REYES PT, DPT Individual | Physical Therapist | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-9008 |
| 1710449335 | ANDREA R KRAMER Individual | Physical Medicine & Rehabilitation | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1174180350 | MS. MARY CATHERINE DEMENT PTA Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1407415706 | MRS. ERVEN SOTILLO TSAO Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 817-6286 |
| 1194294678 | NIKKI LYNNE KARDOUNI OT Individual | Occupational Therapist | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1417011800 | THE MEADOWS OF FAYETTEVILLE INC Organization | Assisted Living Facility | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1437270030 | CROSS CREEK MANOR ASSISTED LIVING LLC Organization | Assisted Living Facility | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1932706561 | NYKEIA BURRIS MOT, OTR/L Individual | Occupational Therapist | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1083280390 | REBECCA LEE PTA Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1255061156 | ADRIENNE MAGILL Individual | Physical Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (669) 254-0355 |
| 1386365898 | FELICIA MONQUE CHRISTIAN COTA/L Individual | Occupational Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (910) 488-4821 |
| 1053012948 | OLIVIA EDINGER Individual | Occupational Therapy Assistant | 231 TREETOP DR FAYETTEVILLE, NC 28311 (843) 754-5147 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255571766, enumerated in the NPI registry as an "organization" on February 23, 2009
The provider is located at 231 Treetop Dr Fayetteville, Nc 28311 and the phone number is (910) 488-4821
This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X
The provider's CLIA number is 34D2207904 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on February 23, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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