CREEKSIDE REHABILITATION AND NURSING (NPI# 1407204746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407204746 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE REHABILITATION AND NURSING |
| Practice Address |
812 Se 48th Ave Portland OR 97215-1724 |
| Practice Telephone | 5032362624 |
| Mailing Telephone | 5032362624 |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | WALTER ERIC MYERS (MANAGING PARTNER) |
| Authorized Official Telephone | 8017094358 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CREEKSIDE REHABILITATION AND NURSING, LLC | 947 S 500 E Ste 105, American Fork, UT 84003 |
| Street Address |
812 SE 48TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-1724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164525077 | Lawrence Convalescent Center | Nursing Facility/Intermediate Care Facility | 812 Se 48th Ave, Portland, OR 97215-1724 | 2006-09-06 |
| 1861897845 | Benjamin Chimenti | Physical Therapist | 812 Se 48th Ave, Portland, OR 97215-1724 | 2014-11-03 |
| 1699015917 | Charles W. Lawrence | Skilled Nursing Facility | 812 Se 48th Ave, Portland, OR 97215-1724 | 2013-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| 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 |
|---|---|---|---|---|
| 1861835456 | Marquis Companies II, Inc. | Skilled Nursing Facility | 319 Ne Russet St, Portland, OR 97211-2815 | 2013-04-12 |
| 1942437298 | Anita August | Skilled Nursing Facility | 300 Nw 8th Ave Apt 707, Portland, OR 97209-3560 | 2009-06-14 |
| 1720151988 | Care Center East Health - Portland, LLC | Skilled Nursing Facility | 11325 Ne Weidler St, Portland, OR 97220-1950 | 2006-11-16 |
| 1659470193 | Eagle Healthcare, Inc | Skilled Nursing Facility | 745 Ne 122nd Ave, Portland, OR 97230-2001 | 2006-09-21 |
| 1932211968 | Marquis Companies I, Inc | Skilled Nursing Facility | 725 Se 202nd Ave, Portland, OR 97233-6105 | 2006-08-31 |
| 1508978537 | Marquis Companies I, Inc | Skilled Nursing Facility | 1475 Se 100th Ave, Portland, OR 97216-2537 | 2006-08-31 |
| 1942312905 | Marquis Companies I, Inc | Skilled Nursing Facility | 6010 Sw Shattuck Rd, Portland, OR 97221-1043 | 2006-08-31 |
| 1205841095 | Adventist Health System Texas, Inc. | Skilled Nursing Facility | 215 Highland Circle Dr, Portland, TN 37148-4918 | 2006-07-30 |
| 1629008651 | Harbor Care Corporation | Skilled Nursing Facility | 3540 Se Francis St, Portland, OR 97202-3350 | 2006-07-04 |
| 1114969912 | West Hills Convalescent Center Limited Partnership | Skilled Nursing Facility | 5701 Sw Multnomah Blvd, Portland, OR 97219-3195 | 2006-06-13 |
| Find all providers in PORTLAND | ||||
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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.