WILLOW RIDGE ASSISTED LIVING
NPI 1215063441
Assisted Living Facility in Charlotte, NC
About Willow Ridge Assisted Living NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLOW RIDGE ASSISTED LIVING (NPI 1215063441) is a healthcare organization registered as an assisted living facility in Charlotte, North Carolina and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through January 30, 2027 and lists Kenneth Hodges, Member Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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 34D2019500
Willow Ridge Assisted Living · Charlotte, NCOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHARLOTTE, NC 28215
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 Willow Ridge Assisted Living LLC's NPI number?
The NPI number for Willow Ridge Assisted Living LLC is 1215063441. It was assigned to this organization in the NPPES registry on February 23, 2007. The provider is doing business as Willow Ridge Assisted Living.
Where is Willow Ridge Assisted Living LLC located?
Willow Ridge Assisted Living LLC is located at 2140 Milton Rd, Charlotte, NC 28215. The listed phone number is (704) 563-7650.
What is Willow Ridge Assisted Living LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Willow Ridge Assisted Living LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2019500) is associated with this NPI, valid through January 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Willow Ridge Assisted Living 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 5 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.
# Willow Ridge Assisted Living · NPI 1215063441
Assisted Living Facility organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since February 23, 2007.
## Identity
- **NPI:** 1215063441 (Entity type: Organization)
- **Enumerated:** February 23, 2007
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** Willow Ridge Assisted Living Llc
- **Organization subpart:** No
- **Authorized official:** Kenneth Hodges, MEMBER MANAGER
## Practice location
- **Address:** 2140 MILTON RD, Charlotte, NC 28215-3319
- **Phone:** (704) 563-7650 · **Fax:** (704) 535-6950
## Record status
- **NPPES last updated:** August 22, 2020
- **Other identifiers:** Medicaid 7805586 (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215063441) · Data from the CMS NPPES public registry.