OrganizationActive
Ocean Trail Convalescent Center, Inc.
NPI 1891761979 · Skilled Nursing Facility · Southport, NC
Provider details
- NPI number
- 1891761979
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Nick Elledge, Vice President(336) 679-8852
- License
- NH0322 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
630 N Fodale Ave
Southport, NC 28461-3538
Phone: (910) 457-9581
Fax: (910) 457-9583
Street-level locationGet directions
Mailing address
Po Box 10249
Southport, NC 28461-0249
Registry dates
- Enumerated
- 2006-02-27
- Last updated
- 2007-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.