PIGEON VALLEY REST HOME LLC
NPI 1528051935
Custodial Care Facility - Adult Care Home in Canton, NC

NPI Status: Active since August 31, 2005

Contact Information

55 LAKE DR
CANTON, NC
ZIP 28716
Phone: (828) 648-2044
Fax: (828) 648-2065

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 34D2193740
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 09-23-2026

About PIGEON VALLEY REST HOME LLC

This page provides the complete NPI Profile along with additional information for Pigeon Valley Rest Home Llc, a provider established in Canton, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1528051935 assigned on August 2005. The practitioner's primary taxonomy code is 311ZA0620X with license number HAL044012 (NC). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mr. Bobby N Leatherwood (Administrator)

NPI
1528051935
Provider Name
PIGEON VALLEY REST HOME LLC
Entity Type
Organization
Location Address
55 LAKE DR CANTON, NC 28716
Location Phone
(828) 648-2044
Location Fax
(828) 648-2065
Mailing Address
100 SILVER BLUFF DR CANTON, NC 28716
Mailing Phone
(828) 648-2044
Mailing Fax
(828) 648-2065
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-31-2005
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
HAL044012
License State
NC
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. BOBBY N LEATHERWOOD

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(828) 648-2044

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7801751MEDICAID (05)NC 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2193740
Facility Type
Assisted Living Facility
Certificate Effective Date
September 24, 2024
Certificate Expiration Date
September 23, 2026
Laboratory Director
LISA L. LEATHERWOOD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pigeon Valley Rest Home Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1528051935, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
3
Doubled → 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 4 + 8 + 0 + 5 + 2 + 9 + 6 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1528051935.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528051935, enumerated as an "organization" on August 31, 2005.

The provider is located at 55 LAKE DR CANTON, NC 28716 and the phone number is (828) 648-2044.

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.