EAGLE ACQUISITION IV LLC (NPI# 1407371149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407371149 |
| Entity Type | Organization |
| Organization Name | EAGLE ACQUISITION IV LLC |
| Other Organization Name | CONCORDIA TRANSITIONAL CARE AND REHABILITATION - ROSE MANOR |
| Practice Address |
4230 N Roxboro St Durham NC 27704-1826 |
| Practice Telephone | (919) 477-9805 |
| Practice Fax Number | 9194795261 |
| Mailing Telephone | 9194779805 |
| Mailing Fax Number | 9194795261 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | BENT PHILIPSON (MANAGING MEMBER) |
| Authorized Official Telephone | 5168693700 |
| 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 |
|---|---|
| Concordia Transitional Care and Rehabilitation - Rose Manor | Doing Business As Name - Organization |
| Street Address |
4230 N ROXBORO ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-1826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487629739 | Billie Candice Pack | Specialist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2006-02-21 |
| 1770149270 | Accordius Health At Rose Manor LLC | Respite Care | 4230 N Roxboro St, Durham, NC 27704-1826 | 2019-05-10 |
| 1679055172 | Loida Castillon Garcia | Physical Therapist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2018-08-30 |
| 1043723653 | Abby Hammel | Speech-Language Pathologist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2017-11-06 |
| 1255598272 | Ricky Alicante Lazo | Physical Therapist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2008-05-19 |
| 1972760981 | Hanah Kaisser Abdulhalim | Physical Therapist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2008-05-19 |
| 1053588665 | Leslie Tayler Wright | Speech-Language Pathologist | 4230 N Roxboro St, Durham, NC 27704-1826 | 2008-05-13 |
| 1871769018 | Ruth Claire Siebers | Skilled Nursing Facility | 4230 N Roxboro St, Durham, NC 27704-1826 | 2008-05-07 |
| 1568638708 | Stephen Benson Farrell | Skilled Nursing Facility | 4230 N Roxboro St, Durham, NC 27704-1826 | 2008-05-07 |
| 1255351052 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 4230 N Roxboro St, Durham, NC 27704-1826 | 2006-07-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
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| 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 |
|---|---|---|---|---|
| 1669821336 | Carver Healthcare LLC | Skilled Nursing Facility | 303 E Carver St, Durham, NC 27704-2135 | 2016-06-03 |
| 1427447549 | Geanda Tilley | Skilled Nursing Facility | 4801 Danube Ln, Apartment #823, Durham, NC 27704-1845 | 2015-01-13 |
| 1447435722 | Pruitthealth - Durham, LLC | Skilled Nursing Facility | 3100 Erwin Road, Durham, NC 27705-4505 | 2008-01-04 |
| 1619157534 | Durham Healthcare LLC | Skilled Nursing Facility | 411 S Lasalle St, Durham, NC 27705-3701 | 2007-11-08 |
| 1851437743 | Twin Maples Health Care Facility | Skilled Nursing Facility | 809 New Haven Rd # R, Durham, CT 06422-2412 | 2007-01-29 |
| 1841390010 | Treyburn Healthcare, Inc | Skilled Nursing Facility | 2059 Torredge Rd, Durham, NC 27712-1767 | 2006-09-25 |
| 1851336754 | Durham Limited Partnership IIi | Skilled Nursing Facility | 303 E. Carver Street, Durham, NC 27704-2135 | 2006-06-17 |
| 1972587376 | The United Methodist Retirement Homes, Incorporated | Skilled Nursing Facility | 2600 Croasdaile Farm Pkwy, Durham, NC 27705-1331 | 2005-11-30 |
| 1386187813 | Treyburn Rehabilitation Center, LLC | Skilled Nursing Facility | 2059 Torredge Rd, Durham, NC 27712-1767 | 2016-12-01 |
| 1831551514 | Durham Rehab Operations LLC | Skilled Nursing Facility | 411 S Lasalle St, Durham, NC 27705-3701 | 2016-03-22 |
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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.