EDENTON PRIME TIME RETIREMENT VILLAGE, LLC
NPI 1174608541
Assisted Living Facility in Edenton, NC

Q: What is Edenton Prime Time Retirement Village, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 26, 2006

106 MARK DR, EDENTON, NC 27932(252) 482-4491 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Edenton Prime Time Retirement Village, Llc NPPES

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

EDENTON PRIME TIME RETIREMENT VILLAGE, LLC (NPI 1174608541) is a healthcare organization registered as an assisted living facility in Edenton, North Carolina and active in the NPI registry since October 2006. The organization lists Guy S Pierce, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1174608541

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEDENTON PRIME TIME RETIREMENT VILLAGE, LLC

Location Address106 MARK DREdenton, NC 27932-1756

Mailing AddressPo Box 1487Kernersville, NC 27285-1487 · (336) 595-1075

Phone(252) 482-4491

Organization SubpartNo

Authorized OfficialGuy S PierceManaging Member · (336) 595-1075

Enumeration DateOctober 26, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1174608541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in NC · HAL-021-005

Definition

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.

106 MARK DR, Edenton, NC 27932

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Other Identifiers 1

Medicaid7804339NC

Other Providers at the Same Location NPPES

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

EDENTON RETIREMENT COMMUNITY, LLC

Assisted Living Facility

106 MARK DR
EDENTON, NC 27932

Chowan County (252) 482-4491

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 Edenton Prime Time Retirement Village, LLC's NPI number?

The NPI number for Edenton Prime Time Retirement Village, LLC is 1174608541. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Edenton Prime Time Retirement Village, LLC located?

Edenton Prime Time Retirement Village, LLC is located at 106 Mark Dr, Edenton, NC 27932. The listed phone number is (252) 482-4491.

What is Edenton Prime Time Retirement Village, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Edenton Prime Time Retirement Village, LLC was last updated on August 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.