SOUTH LEASING (VA) CO., LLC (NPI# 1245771765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245771765 |
| Entity Type | Organization |
| Organization Name | SOUTH LEASING (VA) CO., LLC |
| Other Organization Name | PETERSBURG HEALTHCARE CENTER |
| Practice Address |
287 E South Blvd Petersburg VA 23805-2700 |
| Practice Telephone | 8047331190 |
| Practice Fax Number | 8047330796 |
| Mailing Telephone | 8047331190 |
| Mailing Fax Number | 8047330796 |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |
| Authorized Official Name | CHARLES STOLTZ (CFO) |
| Authorized Official Telephone | 5135301613 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Petersburg Healthcare Center | Doing Business As Name - Organization |
| Street Address |
287 E SOUTH BLVD |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356398572 | Beverly Enterprises - Virginia Inc | Skilled Nursing Facility | 287 E South Blvd, Petersburg, VA 23805-2700 | 2006-05-31 |
| 1508329467 | Arun Selvaratnam | Occupational Therapist | 287 E South Blvd, Petersburg, VA 23805-2700 | 2019-04-08 |
| 1144700162 | Michelle Moss | Speech-Language Pathologist | 287 E South Blvd, Petersburg, VA 23805-2700 | 2018-08-20 |
| 1023504727 | David C Morgan | Speech-Language Pathologist | 287 E South Blvd, Petersburg, VA 23805-2700 | 2018-07-05 |
| 1477060093 | Jennifer Davis | Physical Therapy Assistant | 287 E South Blvd, Petersburg, VA 23805-2700 | 2018-01-04 |
| 1356876569 | Todd A Connor | Occupational Therapist | 287 E South Blvd, Petersburg, VA 23805-2700 | 2017-04-25 |
| 1861861924 | Golden Physician Partners, LLC | Internal Medicine | 287 E South Blvd, Petersburg, VA 23805-2700 | 2015-09-18 |
| 1881852242 | Sarah Marie Schroeder | Occupational Therapist | 287 E South Blvd, Petersburg, VA 23805-2700 | 2008-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| 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 |
|---|---|---|---|---|
| 1497922843 | Dinwiddie Health Care LLC | Skilled Nursing Facility | 46 Diamond Drive, Petersburg, VA 23803-7495 | 2008-05-14 |
| 1487731477 | Good Samaritan Hospital | Skilled Nursing Facility | 801 E Illinois St, Petersburg, IN 47567-8026 | 2006-11-01 |
| 1497856785 | Sunny Acres | Skilled Nursing Facility | 19130 Sunny Acres Rd, Petersburg, IL 62675-7306 | 2006-09-26 |
| 1619924834 | Beverly Enterprises - Virginia, Inc. | Skilled Nursing Facility | 250 Flank Rd, Petersburg, VA 23805-9117 | 2006-05-31 |
| 1356398572 | Beverly Enterprises - Virginia Inc | Skilled Nursing Facility | 287 E South Blvd, Petersburg, VA 23805-2700 | 2006-05-31 |
| 1720035611 | Menard Convalescent Center, Inc | Skilled Nursing Facility | 120 W Antle St, Petersburg, IL 62675-1035 | 2006-05-27 |
| 1770539546 | Hendricks County Hospital | Skilled Nursing Facility | 309 W Pike Ave, Petersburg, IN 47567-8755 | 2006-05-25 |
| 1740270982 | Grant Rehab & Care Center | Skilled Nursing Facility | 127 Early Avenue, Petersburg, WV 26847-9403 | 2005-10-27 |
| 1972044485 | Flank Leasing Co., LLC | Skilled Nursing Facility | 250 Flank Rd, Petersburg, VA 23805-9117 | 2017-03-16 |
| 1922542109 | Dycora Transitional Health - Petersburg LLC | Skilled Nursing Facility | 309 W Pike Ave, Petersburg, IN 47567-8755 | 2016-12-07 |
| Find all providers in PETERSBURG | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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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.