PINEBROOK RESIDENTIAL CENTER II
NPI 1871035469
Custodial Care Facility - Adult Care Home in Yadkinville, NC
NPI Status: Active since November 14, 2016
Contact Information
304 HARRISON AVE
YADKINVILLE, NC
ZIP 27055
Phone: (336) 679-8671
Fax: (336) 679-7500
- Organization
- Custodial Care Facility
- Adult Care Home
- CLIA Number: 34D2023621
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 10-22-2026
About PINEBROOK RESIDENTIAL CENTER II
This page provides the complete NPI Profile along with additional information for Pinebrook Residential Center Ii, a provider established in Yadkinville, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1871035469 assigned on November 2016. The practitioner's primary taxonomy code is 311ZA0620X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Pinebrook Residential Center Ii. The authorized official of this NPI record is Jonathan Swain Short (Cio)
- NPI
- 1871035469
- Provider Legal Name
- INTEGRITY - PINEBROOK, LLC
- Other Organization Name
- PINEBROOK RESIDENTIAL CENTER II
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 304 HARRISON AVE YADKINVILLE, NC 27055
- Location Phone
- (336) 679-8671
- Location Fax
- (336) 679-7500
- Mailing Address
- 4900 KOGER BLVD STE 150 GREENSBORO, NC 27407
- Mailing Phone
- (336) 438-1383
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-14-2016
- Last Update Date
- 11-18-2021
- Code Navigator
Location Map
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
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility |
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
- 34D2023621
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- October 23, 2024
- Certificate Expiration Date
- October 22, 2026
- Laboratory Director
- JAMIE SPARKS-SHELTON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Pinebrook Residential Center Ii 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 1871035469, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1871035469, enumerated as an "organization" on November 14, 2016.
The provider is located at 304 HARRISON AVE YADKINVILLE, NC 27055 and the phone number is (336) 679-8671.
Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.
