THE VILLAGE ON CAMPBELL LLC (NPI# 1003367053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003367053 |
| Entity Type | Organization |
| Organization Name | THE VILLAGE ON CAMPBELL LLC |
| Practice Address |
311 S Campbell St Burgaw NC 28425-5011 |
| Practice Telephone | 9102596007 |
| Practice Fax Number | 9102596111 |
| Mailing Telephone | 9102596007 |
| Mailing Fax Number | 9102596111 |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |
| Authorized Official Name | MR. HUGH BLAINE CAMPBELL III (MANAGER) |
| Authorized Official Telephone | 9103324508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH0461 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC LICENSE | NH0461 | 01 |
| Street Address |
311 S CAMPBELL ST |
| City | BURGAW |
| State | NC |
| Zip Code | 28425-5011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427024991 | Huntington Health Care and Retirement Center Inc | Skilled Nursing Facility | 311 S Campbell St, Burgaw, NC 28425-5011 | 2006-02-24 |
| 1851836118 | The Laurels of Pender, LLC | Skilled Nursing Facility | 311 S Campbell St, Burgaw, NC 28425-5011 | 2016-12-22 |
| 1851835581 | Katie Louise Johnson | Occupational Therapy Assistant | 311 S Campbell St, Burgaw, NC 28425-5011 | 2016-12-14 |
| 1538611959 | Alice Lippman | Speech-Language Pathologist | 311 S Campbell St, Burgaw, NC 28425-5011 | 2016-11-02 |
| 1104372887 | Lisa Ruff | Physical Therapy Assistant | 311 S Campbell St, Burgaw, NC 28425-5011 | 2016-08-31 |
| 1528442308 | Jonathan Martin Noble | Physical Therapy Assistant | 311 S Campbell St, Burgaw, NC 28425-5011 | 2015-07-12 |
| 1508269481 | Emily Mecum | Occupational Therapist | 311 S Campbell St, Burgaw, NC 28425-5011 | 2014-10-06 |
| 1073946521 | Heather Casteen | Occupational Therapy Assistant | 311 S Campbell St, Burgaw, NC 28425-5011 | 2013-08-19 |
| 1982041281 | Haley Elizabeth Welsh | Speech-Language Pathologist | 311 S Campbell St, Burgaw, NC 28425-5011 | 2013-05-28 |
| 1538407341 | Jennifer Mott | Physical Therapy Assistant | 311 S Campbell St, Burgaw, NC 28425-5011 | 2013-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091662 | Chiquitta Williams Lesene | Counselor | 407 E Fremont Street, Burgaw, NC 28425 | 2020-10-22 |
| 1255978912 | David L Populus Jr. | Preventive Medicine | 1638 Hwy 53, Burgaw, NC 28425 | 2019-12-02 |
| 1467948729 | Coastal Horizons Center Inc. | Community/Behavioral Health | 309 Progress Dr., Burgaw, NC 28425 | 2018-07-10 |
| 1629504824 | Kellie Savard | Speech-Language Pathologist | 213 South Wright Street, Unit B, Burgaw, NC 28425 | 2017-05-08 |
| 1578004800 | Alisa Fussell | Speech-Language Pathologist | 10131 Highway 53 W, Burgaw, NC 28425 | 2017-03-20 |
| 1881136851 | Pender Pediatric Therapy, PC | Speech-Language Pathologist | 126 W. Fremont St., Burgaw, NC 28425 | 2016-11-08 |
| 1821424771 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 206 Us Highway 117 S, Burgaw, NC 28425 | 2013-09-24 |
| 1679816193 | Kerry Dawn Daraskavich | Physical Therapist | 311 South Campell Street, Burgaw, NC 28425 | 2013-04-03 |
| 1184985178 | Kerr Drug | Point of Service | 206 Us Route 117 South, Burgaw, NC 28425 | 2012-06-06 |
| 1407117682 | Courtney L Gibbs | Speech-Language Pathologist | 126 W Fremont St, Burgaw, NC 28425 | 2012-06-04 |
| Find all providers in zip 28425 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538137468 | Pender Memorial Hospital, Inc | Skilled Nursing Facility | 507 East Fremont Street, Burgaw, NC 28425-5131 | 2006-03-08 |
| 1427024991 | Huntington Health Care and Retirement Center Inc | Skilled Nursing Facility | 311 S Campbell St, Burgaw, NC 28425-5011 | 2006-02-24 |
| 1851836118 | The Laurels of Pender, LLC | Skilled Nursing Facility | 311 S Campbell St, Burgaw, NC 28425-5011 | 2016-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063756 | Cary Senior Housing I Opco, LLC | Skilled Nursing Facility | 221 Brightmore Dr, Cary, NC 27518-8145 | 2019-10-04 |
| 1629535455 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 621 Chestnut Ridge Pkwy, Blowing Rock, NC 28605-8962 | 2019-02-28 |
| 1871063214 | Vero Health X, LLC | Skilled Nursing Facility | 417 Cloverdale Rd, Sylva, NC 28779-0679 | 2018-11-28 |
| 1821573809 | Carolina Bay Healthcare Center of Wilmington, LLC | Skilled Nursing Facility | 740 Diamond Shoals Rd, Wilmington, NC 28403-4388 | 2018-09-26 |
| 1093228397 | Bellarose Nursing and Rehab Center, Inc. | Skilled Nursing Facility | 200 Bellarose Lake Way, Garner, NC 27529-7049 | 2017-11-08 |
| 1558872333 | Brunswick Health & Rehab Center, LLC | Skilled Nursing Facility | 9600 No 5 School Rd Nw, Ash, NC 28420-2122 | 2017-10-19 |
| 1538684212 | Eagle Acquisition Vi LLC | Skilled Nursing Facility | 901 S Halstead Blvd., Elizabeth City, NC 27909-6920 | 2017-08-03 |
| 1982130811 | Ashton Health and Rehabilitation, LLC | Skilled Nursing Facility | 5533 Burlington Rd, Mc Leansville, NC 27301-9622 | 2017-05-11 |
| 1831625037 | Supplemental Healthcare | Skilled Nursing Facility | 319 Vancouver Drive, Apartment 38g, Fayetteville, NC 28303 | 2017-05-08 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.