{"npi":"1083659692","type":"NPI-2","status":"active","name":{"display":"Tar River Ltc Group, LLC","other":[],"organization_name":"TAR RIVER LTC GROUP, LLC","authorised_official":"Karen Mcdaniel"},"specialty":{"primary_taxonomy":"314000000X","primary_taxonomy_description":"Skilled Nursing Facility","slug":"skilled-nursing-facility","schema_org_specialty":null,"all":[{"code":"261QR0400X","description":"Rehabilitation Clinic/Center","primary":false,"state":"NC","license":"NH0369"},{"code":"314000000X","description":"Skilled Nursing Facility","primary":true,"state":"NC","license":"NH0369"}]},"addresses":[{"purpose":"LOCATION","street_1":"1341 PARADISE RD","city":"EDENTON","state":"NC","postal_code":"279328503","country_code":"US","phone":"2524827481","fax":"2524827674"},{"purpose":"MAILING","street_1":"PO BOX 566","city":"EDENTON","state":"NC","postal_code":"279320566","country_code":"US","phone":"2524827481","fax":"2524827674"}],"license":{"state":"NC","number":"NH0369"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"7802461","state":"NC","issuer":null},{"type_code":"01","label":"Other","value":"00809","state":"NC","issuer":"BC/BS OF NC"},{"type_code":"05","label":"Medicaid","value":"3425164","state":"NC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20110413000779","type_code":"00-18","type_desc":"PART A PROVIDER - SKILLED NURSING FACILITY","state":"NC","pac_id":"9739360785"}]},"enumeration_date":"2006-06-18","last_updated":"2021-07-14","_meta":{"source":"NPPES","snapshot_date":"2021-07-14","doc_url":"https://findmynpi.com/api"}}