CRYSTAL CITY NURSING CENTER, INC. (NPI# 1104861038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104861038 |
| Entity Type | Organization |
| Organization Name | CRYSTAL CITY NURSING CENTER, INC. |
| Other Organization Name | POTOMAC CENTER |
| Practice Address |
1785 S Hayes St Arlington VA 22202-2714 |
| Mailing Address |
101 E State St Kennett Square PA 19348-3109 |
| Practice Telephone | 7039205700 |
| Practice Fax Number | 7039798190 |
| Mailing Telephone | 6109254436 |
| Mailing Fax Number | 6109254351 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | JANE DROPESKEY (CORPORATE MANAGER) |
| Authorized Official Telephone | 6109254231 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2655 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNITED - MAMSI | 241381 | 01 | |
| SOUTHERN HEALTH | 147180 | 01 | |
| CAREFIRST BLUECHOICE | H18 | 01 | |
| CAREFIRST-PROV/INQ# | 02PV | 01 | |
| AMERIGROUP | 47579 | 01 | |
| VA | 004951140 | 05 | |
| AETNA-HMO | 0082366 | 01 | |
| DC | 030909900 | 05 | |
| UNITED - AMERICHOICE | 7100077 | 01 | |
| CAREFIRST - IND/PPO | H18 | 01 |
| Other Name | Type Code |
|---|---|
| Potomac Center | Doing Business As Name - Organization |
| Street Address |
1785 S HAYES ST |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22202-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972163616 | Daniel Shin | Physical Therapist | 1785 S Hayes St, Arlington, VA 22202-2714 | 2019-06-15 |
| 1174041255 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 1785 S Hayes St, Arlington, VA 22202 | 2017-09-08 |
| 1710380670 | Regency Care of Arlington, LLC | Skilled Nursing Facility | 1785 S Hayes St, Arlington, VA 22202-2714 | 2014-10-06 |
| 1811312796 | Senthil Kumar Arumugam | Nursing Facility/Intermediate Care Facility | 1785 S Hayes St, Arlington, VA 22202-2714 | 2014-02-28 |
| 1467880138 | Megan Morris | Speech-Language Pathologist | 1785 S Hayes St, Arlington, VA 22202-2714 | 2013-10-16 |
| 1790078749 | Jamie Hardy Marin | Occupational Therapist | 1785 S Hayes St, Arlington, VA 22202-2714 | 2011-05-24 |
| 1497054043 | Japera Wilson | Speech-Language Pathologist | 1785 S Hayes St, Arlington, VA 22202-2714 | 2011-03-22 |
| 1669774303 | Ami Shah | Physical Therapist | 1785 S Hayes St, Arlington, VA 22202 | 2010-12-01 |
| 1396053955 | Sarah Katherine Sowd | Occupational Therapist | 1785 S Hayes St, Arlington, VA 22202-2714 | 2010-09-16 |
| 1497075998 | Kellie Shaw | Physical Therapy Assistant | 1785 S Hayes St, Arlington, VA 22202-2714 | 2010-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881291474 | Gail Devonna Johnson | Home Health Aide | 2611 S Clark St Suite 700, Arlington, VA 22202 | 2020-10-06 |
| 1194331835 | Keylah Cherri Adams | Home Health Aide | 2611 South Clark Street Suite 700, Arlington, VA 22202 | 2020-09-18 |
| 1902412927 | Briggitte Marie Bradley | Home Health Aide | 2611 S Clark St. Suite 700, Arlington, VA 22202 | 2020-09-16 |
| 1730793027 | Regina Ray | Home Health Aide | 2611 South Clark Street, St.700, Arlington, VA 22202 | 2020-09-03 |
| 1255944328 | Elizabeth Ann Mayes Gross | Home Health Aide | 2611 S. Clark Street, 700, Arlington, VA 22202 | 2020-08-28 |
| 1942826425 | Maria Eugenia Flores | Home Health Aide | 2611 South Clark Street, Suite 700, Arlington, VA 22202 | 2020-06-22 |
| 1013531250 | Alistair Taylor | Student in an Organized Health Care Education/Training Program | Potomac Behavioral Solutions, 2001 Richmond Highway, Suite 800, Arlington, VA 22202 | 2020-06-03 |
| 1194349399 | Solange Abel Anagho | Home Health Aide | 2611 South Clark Street, Suite 700, Arlington, VA 22202 | 2020-06-03 |
| 1083256028 | Home Is Love Home Healthcare, LLC | Home Health | 575 12th Road S, Apt 231, Arlington, VA 22202 | 2019-10-10 |
| 1619521150 | Sarah Elizabeth Young | Physician Assistant | 1601 23rd St S, Arlington, VA 22202 | 2019-08-01 |
| Find all providers in zip 22202 | ||||
| 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 |
|---|---|---|---|---|
| 1598138968 | Consonus | Skilled Nursing Facility | 5102 Haddonstone Dr, Arlington, TX 76017-1890 | 2015-11-07 |
| 1952773830 | Op Ops Arl Tx, LLC | Skilled Nursing Facility | 800 W Randol Mill Rd Fl 6, Arlington, TX 76012-2504 | 2015-10-30 |
| 1336427129 | Green Oaks Scc LLC | Skilled Nursing Facility | 3033 W Green Oaks Blvd, Arlington, TX 76016-2261 | 2011-07-27 |
| 1275773996 | Genesis Health Care | Skilled Nursing Facility | 101 E Randol Mill Rd Ste 100, Arlington, TX 76011-5800 | 2009-02-21 |
| 1477674968 | Fannin County Hospital Authority | Skilled Nursing Facility | 2645 W Randol Mill Rd, Arlington, TX 76012-4228 | 2007-04-02 |
| 1275652604 | Cascade-tarrant Health Services, Ltd | Skilled Nursing Facility | 7100 Matlock Rd, Arlington, TX 76002-3346 | 2007-03-28 |
| 1316072192 | Home for Aged Masons Clinic Nursing Center | Skilled Nursing Facility | 1501 W Division St, Arlington, TX 76012-3818 | 2007-02-22 |
| 1215071832 | Mspf II Arlington Oe, L.p. | Skilled Nursing Facility | 3033 West Green Oaks Blvd, Arlington, TX 76016 | 2007-02-16 |
| 1538246285 | Town Hall Estates Arlington Inc | Skilled Nursing Facility | 824 W Mayfield Rd, Arlington, TX 76015-3647 | 2006-11-01 |
| 1043307226 | Thi of Texas At Arlington II, LLC | Skilled Nursing Facility | 1112 Gibbins Rd, Arlington, TX 76011-5618 | 2006-10-07 |
| Find all providers in ARLINGTON | ||||
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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.