CRYSTAL REHABILITATION AND HEALTHCARE CENTER, LLC (NPI# 1023068723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023068723 |
| Entity Type | Organization |
| Organization Name | CRYSTAL REHABILITATION AND HEALTHCARE CENTER, LLC |
| Practice Address |
902 Sgt John A Pittman Dr Greenwood MS 38930-7343 |
| Practice Telephone | 6624539173 |
| Practice Fax Number | 6624554933 |
| Mailing Telephone | 6624539173 |
| Mailing Fax Number | 6624554933 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-10-17 |
| Authorized Official Name | MICHELLE D MEER (VICE PRESIDENT & SECRETARY) |
| Authorized Official Telephone | 6296260000 |
| Is Organization Subpart | Y |
| Parent Organization Name | ARK MISSISSIPPI HOLDING COMPANY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 501 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 230069 | 05 |
| Street Address |
902 SGT JOHN A PITTMAN DR |
| City | GREENWOOD |
| State | MS |
| Zip Code | 38930-7343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891288940 | Nexion Health At Greenwood, Inc. | Skilled Nursing Facility | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2018-06-13 |
| 1689183246 | Chakita Lavet Beverly | Nurse Practitioner | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2017-09-27 |
| 1033401823 | Joemar R Gongon | Physical Therapist | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2011-05-11 |
| 1336464817 | Laura L Wicker | Physical Therapist | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2010-03-29 |
| 1225367568 | Crystal Health & Rehab of Greenwood, LLC | Physical Therapist | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2009-12-16 |
| 1447589775 | Sacha R Macgown | Occupational Therapist | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447871579 | Stewart Health Care Training Academy | Home Health Aide | 522 West Park Avenue Suite S, Greenwood, MS 38930 | 2020-04-29 |
| 1801386487 | Sunflower-humphreys Counties Progress, Inc. | Case Management | 414 Martin Luther King Dr, Indianola, MS 38930 | 2018-05-18 |
| 1053826610 | Sarah Malone | Counselor | 2504 Browing Road, Greenwood, MS 38930 | 2017-12-05 |
| 1780109850 | Jasmine Turner Edwards | Pharmacist | 2202 Us 82 W Frontage Rd, Greenwood, MS 38930 | 2017-08-09 |
| 1861916199 | Maurice Wright | Social Worker | 522 West Park Avenue, Suite Q-r, Greenwood, MS 38930 | 2017-07-28 |
| 1215464607 | Catherine Johnson | Counselor | 522 West Park Avenue, Greenwood, MS 38930 | 2017-05-16 |
| 1598205262 | Vignesh Kannan | Internal Medicine | Greenwood Leflore Hospital, 1401 River Rd, Greenwood, MS 38930 | 2017-03-01 |
| 1952847691 | Mischa Mccray | Counselor | 804 E Park Ave, Greenwood, MS 38930 | 2017-01-18 |
| 1760933147 | Ginger Caldero | Social Worker | 522 West Park Ave, Greenwood, MS 38930 | 2016-10-20 |
| 1942750617 | Greenwood Leflore Hospital | Psychiatry & Neurology | 1401 River Rd Rm 534, Greenwood, MS 38930 | 2016-10-06 |
| Find all providers in zip 38930 | ||||
| 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 |
|---|---|---|---|---|
| 1750686093 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1200 N State Road 135, Greenwood, IN 46142 | 2011-01-18 |
| 1265569875 | Magnolia Healthcare, Inc. | Skilled Nursing Facility | 1600 W Claiborne Ave, Greenwood, MS 38930-2753 | 2007-02-28 |
| 1770670960 | Thi of South Carolina At Greenwood, LLC | Skilled Nursing Facility | 1415 Parkway, Greenwood, SC 29646-4044 | 2006-10-07 |
| 1265422968 | Riverview Hospital | Skilled Nursing Facility | 937 Fry Rd, Greenwood, IN 46142-1820 | 2005-10-24 |
| 1598760456 | Wesley Commons | Skilled Nursing Facility | 1110 Marshall Rd, Greenwood, SC 29646 | 2005-06-16 |
| 1891288940 | Nexion Health At Greenwood, Inc. | Skilled Nursing Facility | 902 Sgt John A Pittman Dr, Greenwood, MS 38930-7343 | 2018-06-13 |
| 1366883811 | Hancock Regional Hospital | Skilled Nursing Facility | 377 Westridge Blvd, Greenwood, IN 46142-2137 | 2013-07-12 |
| 1992953582 | Greenwood Health & Living Center | Skilled Nursing Facility | 937 Fry Rd, Greenwood, IN 46142-1820 | 2008-09-08 |
| 1457573875 | Greenwood Regional Rehabilitation | Skilled Nursing Facility | 1530 Parkway, Greenwood, SC 29646-4027 | 2007-05-03 |
| 1245274984 | Greenwood Leflore Hospital | Skilled Nursing Facility | 1401 River Rd, Greenwood, MS 38930-4030 | 2006-06-15 |
| Find all providers in GREENWOOD | ||||
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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.