Basic Information
| Provider Information | |||||||||
| NPI: | 1982130811 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASHTON HEALTH AND REHABILITATION, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ASHTON HEALTH AND REHABILITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5533 BURLINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MC LEANSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273019622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366980045 | ||||||||
| FaxNumber: | 9198829771 | ||||||||
| Practice Location | |||||||||
| Address1: | 5533 BURLINGTON RD | ||||||||
| Address2: | |||||||||
| City: | MC LEANSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273019622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366980045 | ||||||||
| FaxNumber: | 9198829771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SPRENGER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9196089123 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | NH0625 | NC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 34D1104870 | 01 | NC | CLIA | OTHER | MA2131251 | 01 | NC | DEA CONTROLLED SUBSTANCE REGISTRATION NUMBER | OTHER | NC-AA 0000 3899 | 01 | NC | NORTH CAROLINA CONTROLLED SUBSTANCES REGISTRATION NUMBER | OTHER | 3405548 | 05 | NC | MEDICAID |