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MALLARD RIDGE ASSISTED LIVING
NPI 1013473537
Custodial Care Facility - Adult Care Home in Clemmons, NC

Active since February 20, 2019CLIA 34D2149405 · Waiver
9420 N NC HWY 150, CLEMMONS, NC 27012(336) 775-2205(336) 775-2207 Get Directions Write a Review

NPPES record last updated: April 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 22, 2020, Mar 5, 2019, Feb 20, 2019 (3 updates tracked since 2019).

About Mallard Ridge Assisted Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLARD RIDGE ASSISTED LIVING (NPI 1013473537) is a healthcare organization registered as an adult care home in Clemmons, North Carolina and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through June 3, 2028 and lists Cindy Ann Neagle, Vp Finance, as its authorized official.

NPPES Registry Identity

NPI1013473537
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameRIDGE CARE MANAGEMENT, INC.
Location Address9420 N NC HWY 150Clemmons, NC 27012-6853
Mailing Address853 Old Winston Rd Ste 118Kernersville, NC 27284-8781 · (336) 993-7555 · Fax (336) 993-6111
Phone(336) 775-2205
Fax(336) 775-2207
Organization SubpartNo
Authorized OfficialCindy Ann NeagleVp Finance · (336) 993-7555
Enumeration DateFebruary 20, 2019
Last NPPES UpdateApril 22, 20203 updates tracked since enumeration
NPPES CertifiedApril 22, 2020
✔ NPI 1013473537 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
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.
9420 N NC HWY 150, Clemmons, NC 27012
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Other Names 1

Other NameMallard Ridge Assisted Living

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2149405

Mallard Ridge Assisted Living · Clemmons, NC
Active · expires Jun 3, 2028
CLIA Number34D2149405
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 4, 2026
Certificate Expiration DateJune 3, 2028
Laboratory DirectorAmanda-Kay Edwards
Laboratory Phone(336) 775-2205
Laboratory LocationMallard Ridge Assisted Living9420 N Nc Highway 150, Clemmons, NC 27012
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RSS/CLEMMONS OPERATIONS, LLC
Custodial Care Facility (Adult Care Home)
9420 N NC HWY 150
CLEMMONS, NC 27012
Forsyth County (336) 895-1293
KATHY SANGER OT
Occupational Therapist
9420 N NC HWY 150
CLEMMONS, NC 27012
Forsyth County (336) 895-1293

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ridge Care Management, Inc.'s NPI number?

The NPI number for Ridge Care Management, Inc. is 1013473537. It was assigned to this organization in the NPPES registry on February 20, 2019. The provider is also known as Mallard Ridge Assisted Living.

Where is Ridge Care Management, Inc. located?

Ridge Care Management, Inc. is located at 9420 N Nc Hwy 150, Clemmons, NC 27012. The listed phone number is (336) 775-2205.

What is Ridge Care Management, Inc.'s specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Ridge Care Management, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2149405) is associated with this NPI, valid through June 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ridge Care Management, Inc. was last updated on April 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.