AUTUMN CORPORATION (NPI# 1154307890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154307890 |
| Entity Type | Organization |
| Organization Name | AUTUMN CORPORATION |
| Other Organization Name | AUTUMN CARE OF SUFFOLK |
| Practice Address |
2580 Pruden Blvd Suffolk VA 23434-4229 |
| Mailing Address |
26691 Richmond Rd Bedford Heights OH 44146-1421 |
| Practice Telephone | 7579342363 |
| Practice Fax Number | 7579251474 |
| Mailing Telephone | 2162925706 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2019-01-21 |
| Authorized Official Name | WILLIAM I. WEISBERG (VICE PRESIDENT) |
| Authorized Official Telephone | 2162925706 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2488 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 5952588 | 05 |
| Other Name | Type Code |
|---|---|
| Autumn Care of Suffolk | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376932889 | Autumn Corporation | Skilled Nursing Facility | 19530 Mt. Zion Pkwy, Cornelius, NC 28031 | 2015-01-21 |
| 1083917413 | Autumn Corporation | Skilled Nursing Facility | 1401 71st School Rd, Fayetteville, NC 28314-2814 | 2010-12-07 |
| 1942467964 | Autumn Corporation | Custodial Care Facility | 451 N Winstead Ave, Rocky Mount, NC 27804-2230 | 2008-05-19 |
| 1336310697 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 311 W Phifer St, Marshville, NC 28103-1322 | 2008-03-14 |
| 1437320793 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 360 Old Balsam Rd, Waynesville, NC 28786-8097 | 2008-03-14 |
| 1619148996 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 440 Ingram Road Ext, King, NC 27021-8208 | 2008-03-14 |
| 1174794580 | Autumn Corporation | Nursing Facility/Intermediate Care Facility | 307 Oakland Ave., Drexel, NC 28619-1278 | 2008-03-13 |
| 1205812427 | Autumn Corporation | Skilled Nursing Facility | 320 N. Main St, Rich Square, NC 27869 | 2005-12-20 |
| 1417933615 | Autumn Corporation | Skilled Nursing Facility | 440 Ingram Road Ext., King, NC 27021 | 2005-12-20 |
| 1275519506 | Autumn Corporation | Skilled Nursing Facility | 307 Oakland Ave, Morganton, NC 28655-6928 | 2005-12-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | AUTUMN CORPORATION | 26691 Richmond Rd, Bedford, Ohio 44146-1421 |
| Indiana Business Entities | AUTUMN CORPORATION II | 451 North Winstead Avenue, Post Office Box 7728, Rocky Mount, NC 27804 |
| Connecticut Business Registrations | AUTUMN CORPORATION OF RHODE ISLAND THE | 12 Bassett St, Providence, RI 02903 |
| Street Address |
2580 PRUDEN BLVD |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184691 | Kathy Collado | Physical Therapist | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2020-08-13 |
| 1518595883 | Veronica Hope Balko | Occupational Therapist | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2020-03-31 |
| 1912539487 | Joshua Landon Vick | Physical Therapy Assistant | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2020-02-12 |
| 1518505700 | Ruth Etiosa Auld | Speech-Language Pathologist | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-12-18 |
| 1558903500 | William Hernandez | Physical Medicine & Rehabilitation | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-10-10 |
| 1114569399 | Jocelyn Aleece Griffin | Occupational Therapy Assistant | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-10-09 |
| 1427608918 | Christian Ian Lacson Empeno | Physical Therapist | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-09-17 |
| 1871052951 | Aura Clarke-walker | Occupational Therapist | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-03-18 |
| 1013474881 | Iva Mananquil | Physical Therapy Assistant | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2019-02-27 |
| 1427530732 | Lisa C Carter | Social Worker | 2580 Pruden Blvd, Suffolk, VA 23434-4229 | 2018-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1912561713 | Revivication Counseling Services | Counselor | 814 Cripple Creek Lane, Suffolk, VA 23434 | 2019-04-26 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| Find all providers in zip 23434 | ||||
| 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 |
|---|---|---|---|---|
| 1447333141 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 200 W Constance Rd, Suffolk, VA 23434-4413 | 2006-10-24 |
| 1073500310 | Lake Prince Center, Inc. | Skilled Nursing Facility | 100 Anna Goode Way, Suffolk, VA 23434-9236 | 2005-10-03 |
| 1811412570 | Eagle Acquisition Xii LLC | Skilled Nursing Facility | 200 W Constance Rd, Suffolk, VA 23434-4413 | 2017-08-03 |
| 1689916884 | Sentara Hospitals | Skilled Nursing Facility | 2800 Godwin Blvd, Suffolk, VA 23434-8038 | 2013-03-26 |
| 1285891028 | Debbie Barton | Skilled Nursing Facility | 200 W Constance Rd, Suffolk, VA 23434-4413 | 2008-05-20 |
| 1053578807 | Angela C Flynn | Skilled Nursing Facility | 200 W Constance Rd, Suffolk, VA 23434-4413 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
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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.