Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1124015458 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1124015458","entity_type_code":"2"} |
| pecos_enrlmt_id | O20100622000579 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1124015458","rule":"D-PECOS","enrlmt_id":"O20100622000579"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | JEFFREY J GILLIAM | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0042353765","source_pk":92703,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | TAMMY JONES | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"02/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0547604993","source_pk":92705,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | LAMONT D MADDOX | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0547798050","source_pk":92706,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | ANTHONY BRANCH | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0749199362","source_pk":92708,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | GREGORY ALCORN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0941330021","source_pk":92710,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | MICHELLE HORTON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1052789203","source_pk":92712,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | MARISSA K MCNALLY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"07/25/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1456889963","source_pk":92714,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | KATHY WOOD | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1850724857","source_pk":92715,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | KENNETH WAYNE CLAPP | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2264928449","source_pk":92717,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | PAUL ALLEN GRAY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2365886710","source_pk":92719,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | DIANA R SULLIVAN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2365970878","source_pk":92721,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | MARGARET N WILEY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2466797527","source_pk":92723,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | PARKER DAUGHTRY HOWELL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2013","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2769815752","source_pk":92725,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | HEATHER SLOAN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"04/12/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173019353","source_pk":92727,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | SUSAN STONE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3779494364","source_pk":92728,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | LAWRENCE RAY BOLICK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3779960471","source_pk":92730,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | SHANE SMITH | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3870961022","source_pk":92732,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | JULIUS W ABERNETHY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789052937","source_pk":92734,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | JODY STREET | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5092159442","source_pk":92736,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | JAN BRIGGS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/19/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5395999072","source_pk":92738,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | RONALD BRADLEY THIE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2015","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496188484","source_pk":92739,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | EVERYAGE (NC) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"12/15/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5698684215","source_pk":92741,"type_owner":"O","enrollment_id":"O20100622000579","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | CHARLES ERDMAN (VA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6608767835","source_pk":92742,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | FRIEDA MENZER (NC) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800042912","source_pk":92744,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | AIMEE N REIMANN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"06/01/2013","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800862764","source_pk":92745,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | MILLS HUNTER MARCH | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7113350117","source_pk":92747,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | LEE B SYRIA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"10/01/2012","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7315080033","source_pk":92749,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
| ← owns | CORY SCOTT TOBIN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9032542030","source_pk":92752,"type_owner":"I","enrollment_id":"O20100622000579","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EVERYAGE"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1124015458 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2005-10-03 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | EVERYAGE | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | NC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1124015458: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…