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SUMMIT PLACE OF MOORESVILLE
NPI 1447538657
Assisted Living Facility in Mooresville, NC

Active since July 22, 2011CLIA 34D1009395 · Waiver
128 BRAWLEY SCHOOL RD, MOORESVILLE, NC 28117(704) 799-2712(704) 799-2719 Get Directions Write a Review

NPPES record last updated: June 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2020, May 13, 2016 (2 updates tracked since 2016).

About Summit Place Of Mooresville NPPES

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

SUMMIT PLACE OF MOORESVILLE (NPI 1447538657) is a healthcare organization registered as an assisted living facility in Mooresville, North Carolina and active in the NPI registry since July 2011. The organization holds a CLIA Waiver certificate valid through February 12, 2027 and lists Jennifer F Mintzer, President & Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1447538657
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSNH SE MOORESVILLE TENANT LLC
Location Address128 BRAWLEY SCHOOL RDMooresville, NC 28117-9102
Mailing Address255 Washington St Ste 300Newton, MA 02458-1634 · (617) 796-8350 · Fax (617) 796-8349
Phone(704) 799-2712
Fax(704) 799-2719
Organization SubpartYes
Authorized OfficialJennifer F MintzerPresident & Chief Operating Officer · (617) 796-8350
Enumeration DateJuly 22, 2011
Last NPPES UpdateJune 23, 20202 updates tracked since enumeration
NPPES CertifiedJune 23, 2020
✔ NPI 1447538657 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-049-030
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.
128 BRAWLEY SCHOOL RD, Mooresville, NC 28117
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Other Names 1

Doing Business AsSummit Place Of Mooresville

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 34D1009395

Summit Place Of Mooresville · Mooresville, NC
Active · expires Feb 12, 2027
CLIA Number34D1009395
Laboratory TypeAssisted Living Facility
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorEmily R. Paxton
Laboratory Phone(704) 799-2712
Laboratory LocationSummit Place Of Mooresville128 Brawley School Rd, Mooresville, NC 28117
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 4

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

KIRSTYN BOWMAN
Physical Therapist
128 BRAWLEY SCHOOL RD
MOORESVILLE, NC 28117
Iredell County (980) 447-2511
MISS KELLI YORK M.ED., CCC-SLP
Speech-Language Pathologist
128 BRAWLEY SCHOOL RD
MOORESVILLE, NC 28117
Iredell County (980) 447-2511
BARRINGTON ON THE GREEN PROPERTIES, LLC
Assisted Living Facility
128 BRAWLEY SCHOOL RD
MOORESVILLE, NC 28117
Iredell County (704) 799-2712
KYLIE CELESTE FICK COTA
Occupational Therapy Assistant
128 BRAWLEY SCHOOL RD
MOORESVILLE, NC 28117
Iredell County (704) 799-2712

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 Snh SE Mooresville Tenant LLC's NPI number?

The NPI number for Snh SE Mooresville Tenant LLC is 1447538657. It was assigned to this organization in the NPPES registry on July 22, 2011. The provider is doing business as Summit Place Of Mooresville.

Where is Snh SE Mooresville Tenant LLC located?

Snh SE Mooresville Tenant LLC is located at 128 Brawley School Rd, Mooresville, NC 28117. The listed phone number is (704) 799-2712.

What is Snh SE Mooresville Tenant LLC's specialty?

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

Does Snh SE Mooresville Tenant LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1009395) is associated with this NPI, valid through February 12, 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 Snh SE Mooresville Tenant LLC was last updated on June 23, 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.