PREMIER PROVIDERS INC DBA BRADNER VILLAGE HEALTH CARE CENTER (NPI# 1124025457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124025457 |
Entity Type | Organization |
Organization Name | PREMIER PROVIDERS INC DBA BRADNER VILLAGE HEALTH CARE CENTER |
Other Organization Name | BRADNER VILLAGE HEALTH CARE CENTER |
Practice Address |
505 N Bradner Ave Marion IN 46952-2449 |
Practice Telephone | 7656623981 |
Practice Fax Number | 7656623981 |
Mailing Telephone | 7656623981 |
Mailing Fax Number | 7656623981 |
Enumeration Date | 2005-07-01 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. ERIC WALTS (CEO) |
Authorized Official Telephone | 7656623981 |
Authorized Official Credential | MBA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | IN | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Bradner Village Health Care Center | Other Name - Individual/Organization |
Street Address |
505 N BRADNER AVE |
City | MARION |
State | IN |
Zip Code | 46952-2449 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215111067 | Johnson Memorial Hospital | Skilled Nursing Facility | 505 N Bradner Ave, Marion, IN 46952-2449 | 2007-12-27 |
1063624245 | Gerri Colleen Click | Physical Therapy Assistant | 505 N Bradner Ave, Marion, IN 46952-2449 | 2007-05-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982245874 | John Robert Searfoss Sr. | Counselor | 314 S Norton Ave., Marion, IN 46952 | 2019-10-02 |
1063069755 | Andrea Marie Brown | Behavior Technician | 2315 W 2nd St, Marion, IN 46952 | 2019-08-19 |
1548767767 | Johnnie Micheal Hiles | Counselor | 315 South Norton Ave., Marion, IN 46952 | 2018-04-13 |
1669979936 | Sheila Ann Johnson | Counselor | 315 S. Norton Ave, Marion, IN 46952 | 2018-04-12 |
1679070957 | Marissa Lynn Castillo | Counselor | 315 S Norton Avenue, Marion, IN 46952 | 2018-04-12 |
1326545609 | Eumalla Lampkins | Case Manager/Care Coordinator | 315 South Norton Avenue, Marion, IN 46952 | 2018-04-12 |
1285011650 | Forefront Dermatology, S.c. | Dermatology | 330 N Wabash Ave Ste 360, Marion, IN 46952 | 2015-05-05 |
1649510959 | Cancer Services of Grant County Inc. | Prosthetic/Orthotic Supplier | 305 S. Norton Ave., Marion, IN 46952 | 2013-02-22 |
1326350844 | Beth Ellen Krouse | Speech-Language Pathologist | 1800 Wabash Ave, Suite 200, Marion, IN 46952 | 2010-07-13 |
1093032138 | Thomas Alfred Beck | General Practice | 919 Euclid Avenue, Marion, IN 46952 | 2010-04-29 |
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Taxonomy Code | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740211481 | Harding Pointe, Inc | Nursing Facility/Intermediate Care Facility | 340 Oak St, Marion, OH 43302-2263 | 2006-07-05 |
1356398853 | Sunbridge Marion Health Care LLC | Nursing Facility/Intermediate Care Facility | 524 James Way, Marion, OH 43302-7801 | 2006-05-28 |
1093979676 | Creative Health Solutions | Nursing Facility/Intermediate Care Facility | 1800 N Wabash Rd Ste 200, Marion, IN 46952-1300 | 2008-07-14 |
1356512602 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 1264 Airport Rd, Marion, NC 28752-3190 | 2008-03-14 |
1740311620 | Hospital District No 1 Marion Co | Nursing Facility/Intermediate Care Facility | 535 S Freeborn St, Marion, KS 66861-1256 | 2007-03-09 |
1144269630 | Hospital District No 1 Marion Co | Nursing Facility/Intermediate Care Facility | 535 S Freeborn St, Marion, KS 66861-1256 | 2006-06-06 |
1033173323 | Southwestern Virginia Mental Health Institute | Nursing Facility/Intermediate Care Facility | 340 Bagley Circle, Marion, VA 24354-3102 | 2006-04-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871040659 | Stephanie Hentrup | Nursing Facility/Intermediate Care Facility | 621 E 20th St, Ferdinand, IN 47532-9220 | 2016-09-08 |
1912354630 | Denise Chambery | Nursing Facility/Intermediate Care Facility | 5707 W 122nd Pl, Crown Point, IN 46307-8778 | 2016-05-23 |
1124494760 | Maplemanor Christian Home, Inc. | Nursing Facility/Intermediate Care Facility | 643 W Utica St, Sellersburg, IN 47172-1163 | 2015-08-18 |
1174868822 | Daviess County Hospital | Nursing Facility/Intermediate Care Facility | 120 East Miller Drive, Bloomington, IN 47407-6538 | 2012-12-06 |
1134493281 | Adams County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 9802 Coldwater Road, Fort Wayne, IN 46825 | 2012-03-06 |
1447481049 | Larry Wayne Sims | Nursing Facility/Intermediate Care Facility | 1236 Lincoln Ave, Evansville, IN 47714-1056 | 2009-07-30 |
1720253313 | Davis Elderly Care, LLC | Nursing Facility/Intermediate Care Facility | 5139 S Hanover Saluda Rd, Hanover, IN 47243-9212 | 2008-04-24 |
1750585766 | Gosport Care, Inc. | Nursing Facility/Intermediate Care Facility | 27 S. 7th St., Gosport, IN 47433-0099 | 2007-06-13 |
1790986792 | Evansville Protestant Home Inc. | Nursing Facility/Intermediate Care Facility | 3701 Washington Ave, Evansville, IN 47714-0544 | 2007-05-29 |
1881816148 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 505 North Gavin Street, Muncie, IN 47303 | 2007-05-03 |
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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.