PRIDDY MANOR ASSISTED LIVING
NPI 1053745471
Custodial Care Facility - Adult Care Home in King, NC

Q: What is Priddy Manor Assisted Living's NPI number?

The NPI number for Priddy Manor Assisted Living is 1053745471. It was assigned to this organization in the NPPES registry on August 22, 2013.

Q: What is Priddy Manor Assisted Living's specialty?

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

Active since August 22, 2013CLIA 34D2149669 · Waiver

1294 PRIDDY ROAD, KING, NC 27021(336) 983-3068(336) 995-6098 Get Directions Write a Review

NPPES record last updated: August 22, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Priddy Manor Assisted Living NPPES

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

PRIDDY MANOR ASSISTED LIVING (NPI 1053745471) is a healthcare organization registered as an adult care home in King, North Carolina and active in the NPI registry since August 2013. The organization holds a CLIA Waiver certificate valid through June 7, 2028 and lists Steve Bailey, Vp, as its authorized official.

NPPES Registry Identity

NPI1053745471

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NamePRIDDY MANOR ASSISTED LIVING

Location Address1294 PRIDDY ROADKing, NC 27021

Mailing Address853 Old Winston Rd, Suite 118Kernersville, NC 27284-7143 · (336) 993-7555 · Fax (336) 993-6111

Phone(336) 983-3068

Fax(336) 995-6098

Organization SubpartNo

Authorized OfficialSteve BaileyVp · (336) 993-7555

Enumeration DateAugust 22, 2013

✔ NPI 1053745471 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

License✔ Licensed in NC · HAL085009

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.

1294 PRIDDY ROAD, King, NC 27021

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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 34D2149669

Priddy Manor Assisted Living · King, NC

Active · expires Jun 7, 2028

CLIA Number34D2149669

Laboratory TypeAssisted Living Facility

Certificate Effective DateJune 8, 2026

Certificate Expiration DateJune 7, 2028

Laboratory DirectorChristy S. Bower

Laboratory Phone(336) 983-3068

Laboratory LocationPriddy Manor Assisted Living1294 Priddy Road, King, NC 27021

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Priddy Manor Assisted Living's NPI number?

The NPI number for Priddy Manor Assisted Living is 1053745471. It was assigned to this organization in the NPPES registry on August 22, 2013.

Where is Priddy Manor Assisted Living located?

Priddy Manor Assisted Living is located at 1294 Priddy Road, King, NC 27021. The listed phone number is (336) 983-3068.

What is Priddy Manor Assisted Living's specialty?

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

Does Priddy Manor Assisted Living hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2149669) is associated with this NPI, valid through June 7, 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 Priddy Manor Assisted Living was last updated on August 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.