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FOREST HEIGHTS SENIOR LIVING COMMUNITY
NPI 1508919101
Assisted Living Facility in Winston-salem, NC

Active since January 19, 2007CLIA 34D2023605 · Waiver
2500 POLO RIDGE CT, WINSTON-SALEM, NC 27106(336) 722-7118(336) 722-9785 Get Directions Write a Review

NPPES record last updated: June 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

About Forest Heights Senior Living Community NPPES

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

FOREST HEIGHTS SENIOR LIVING COMMUNITY (NPI 1508919101) is a healthcare organization registered as an assisted living facility in Winston-salem, North Carolina and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Katherine E Potter, President & Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1508919101
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameFIVE STAR QUALITY CARE - OBX OPERATOR, LLC
Location Address2500 POLO RIDGE CTWinston-salem, NC 27106
Mailing Address400 Centre StreetNewton, MA 02458 · (617) 796-8387 · Fax (617) 796-8385
Phone(336) 722-7118
Fax(336) 722-9785
Organization SubpartYes
Authorized OfficialKatherine E PotterPresident & Chief Executive Officer · (617) 796-8387
Enumeration DateJanuary 19, 2007
Last NPPES UpdateJune 23, 20202 updates tracked since enumeration
NPPES CertifiedJune 23, 2020
✔ NPI 1508919101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
2500 POLO RIDGE CT, Winston-salem, NC 27106
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Other Names 1

Doing Business AsForest Heights Senior Living Community

Other Identifiers 1

Medicaid7806153NC

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 34D2023605

Forest Heights · Winston-Salem, NC
Active · expires Apr 26, 2027
CLIA Number34D2023605
Laboratory TypeAdult Care Home
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorJoshua James
Laboratory Phone(336) 722-7118
Laboratory LocationForest Heights2500 Polo Ridge Court, Winston-Salem, NC 27106
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 8

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

MS. CHRISTY DAVIS-COTTRELL MA CCC/SLP
Speech-Language Pathologist
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 734-1734
KATHERINE SOBIE OTR/L
Occupational Therapist
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 734-1734
MELISSA MOOSE OT
Occupational Therapist
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 734-1734
SUSAN JONES
Physical Therapy Assistant
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 734-1734
THOMAS VERNON LEWIS
Occupational Therapist
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 722-7118
PRUITTPLACE - WINSTON SALEM LLC
Assisted Living Facility
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (770) 279-6200
JASON CATON
Physical Therapy Assistant
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (704) 780-3362
NATALIE TORRES CEDILLO OTR/L
Occupational Therapist
2500 POLO RIDGE CT
WINSTON SALEM, NC 27106
Forsyth County (336) 774-4557

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 Five Star Quality Care - Obx Operator, LLC's NPI number?

The NPI number for Five Star Quality Care - Obx Operator, LLC is 1508919101. It was assigned to this organization in the NPPES registry on January 19, 2007. The provider is doing business as Forest Heights Senior Living Community.

Where is Five Star Quality Care - Obx Operator, LLC located?

Five Star Quality Care - Obx Operator, LLC is located at 2500 Polo Ridge Ct, Winston-Salem, NC 27106. The listed phone number is (336) 722-7118.

What is Five Star Quality Care - Obx Operator, LLC's specialty?

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

Does Five Star Quality Care - Obx Operator, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2023605) is associated with this NPI, valid through April 26, 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 Five Star Quality Care - Obx Operator, 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.