CROFTON CONVALESCENT CENTER, INC. (NPI# 1093782468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093782468 |
| Entity Type | Organization |
| Organization Name | CROFTON CONVALESCENT CENTER, INC. |
| Practice Address |
2131 Davidsonville Rd Crofton MD 21114-1632 |
| Practice Telephone | 4107211000 |
| Practice Fax Number | 4107212749 |
| Mailing Telephone | 4107211000 |
| Mailing Fax Number | 4107212749 |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2012-08-14 |
| Authorized Official Name | MR. PHILIP J GORDON (NURSING HOME ADMINISTRATOR) |
| Authorized Official Telephone | 4107211000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 02-011 | MD | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 021797200 | 05 |
| Street Address |
2131 DAVIDSONVILLE RD |
| City | CROFTON |
| State | MD |
| Zip Code | 21114-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942876 | Mark Gillies Cu | Occupational Therapy Assistant | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2020-08-17 |
| 1689209033 | Christina Morrison | Physical Medicine & Rehabilitation | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2020-03-05 |
| 1558991935 | Ashleigh Conatser | Physical Therapy Assistant | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2020-01-24 |
| 1265062954 | Advanced Dialysis Center, LLC | Clinic/Center | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2020-01-22 |
| 1538704614 | Christina Cole | Physical Therapy Assistant | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-11-12 |
| 1962043398 | Areej Yamin | Speech-Language Pathologist | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-10-07 |
| 1730737073 | Kurt Michael Rinehart | Physical Therapist | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-08-29 |
| 1043868649 | Robin Demaso | Occupational Therapy Assistant | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-08-28 |
| 1831746718 | Michael Beeman | Physical Therapy Assistant | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-08-24 |
| 1649827502 | Ma Elvira Nayal | Physical Therapist | 2131 Davidsonville Rd, Crofton, MD 21114-1632 | 2019-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942857156 | Betty J Wanjau | Occupational Therapy Assistant | 2131 Davidsoville Rd, Crofton, MD 21114 | 2019-08-22 |
| 1972067494 | Brightview Crofton, LLC | Alzheimer Center (Dementia Center) | 1301 Clarity Drive, Crofton, MD 21114 | 2019-01-29 |
| 1225522147 | Jodie Rich | Pharmacist | Shoppers, 1649 Crofton Center, Crofton, MD 21114 | 2018-06-15 |
| 1447769054 | Danielle Ellen Barton | Counselor | 1627 Ardsley Place, Crofton, MD 21114 | 2017-09-26 |
| 1093250474 | Holistic, Re-education, & Empowering Serices, LLC | Community/Behavioral Health | 2305 Fairhaven Lane, Crofton, MD 21114 | 2016-12-21 |
| 1326594201 | Evette Shields | Adult Companion | 1617 Parkridge Circle #152, Crofton, MD 21114 | 2016-08-30 |
| 1861866832 | Kathryn Bucher | Occupational Therapist | 2435 Bolton Lane, Crofton, MD 21114 | 2015-11-13 |
| 1730512062 | James Martin Schwartz | Dentist | 1286 Route 3 North, Crofton, MD 21114 | 2013-08-09 |
| 1184923088 | Jean Louise Dela Torre | Speech-Language Pathologist | 1672 Carlyle Dr. Apt. E, Crofton, MD 21114 | 2011-03-18 |
| 1295033488 | Nancy Fox Royster | Registered Nurse | 1004 Broderick Court, Crofton, MD 21114 | 2011-03-11 |
| Find all providers in zip 21114 | ||||
| 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. |
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| 1073073623 | Home Care Solutions LLC | Skilled Nursing Facility | 620 Sanders Ln, Oakland, MD 21550-7773 | 2019-03-20 |
| 1972016905 | Prince Georges Post Acute LLC | Skilled Nursing Facility | 1051 Brightseat Road, Landover, MD 20785 | 2017-11-13 |
| 1073042479 | The Lions Center for Rehabilitation and Extended Care, Inc. | Skilled Nursing Facility | 901 Seton Drive, Cumberland, MD 21502 | 2017-06-08 |
| 1518493774 | Bea's Hive Assisted Living | Skilled Nursing Facility | 3014 Nightside Drive, Upper Marlboro, MD 20774 | 2017-05-10 |
| 1417490277 | Grace Compassionate Health Care | Skilled Nursing Facility | 113 River Forest Ln, Ft Washington, MD 20744-6240 | 2016-11-28 |
| 1447705967 | Sarah Lorraine Bensinger | Skilled Nursing Facility | 9 N Summit Dr Apt 202, Gaithersburg, MD 20877-3056 | 2016-08-25 |
| 1578927489 | 1046 North Point, LLC | Skilled Nursing Facility | 1046 North Point Rd, Baltimore, MD 21224-3307 | 2016-04-06 |
| 1578927588 | Pineview Extended Care Centre, Inc. | Skilled Nursing Facility | 9016 Pine View Lane, Clinton, MD 20735-3229 | 2016-04-06 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1881063154 | Supplemental Health | Skilled Nursing Facility | 1292 Limit Ave, Idlewylde, MD 21239-1747 | 2015-09-17 |
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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.