MIRA VISTA CORPORATION (NPI# 1437214970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437214970 |
| Entity Type | Organization |
| Organization Name | MIRA VISTA CORPORATION |
| Other Organization Name | MIRA VISTA CARE CENTER |
| Practice Address |
300 S 18th St Mount Vernon WA 98274-4661 |
| Practice Telephone | 3604241320 |
| Practice Fax Number | 3608481948 |
| Mailing Telephone | 3604241320 |
| Mailing Fax Number | 3608481948 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JAMES SCOTT HALE (ADMINISTRATOR) |
| Authorized Official Telephone | 3604241320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 957 | WA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 4195707 | 05 |
| Other Name | Type Code |
|---|---|
| Mira Vista Care Center | Doing Business As Name - Organization |
| Street Address |
300 S 18TH ST |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98274-4661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124665815 | Jessica Monroe | Occupational Therapist | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2019-12-02 |
| 1528580222 | Lindsey Greathouse | Speech-Language Pathologist | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2017-07-13 |
| 1124567359 | Kasey Marie Swanson | Occupational Therapist | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2017-02-21 |
| 1871950410 | Amber Jean Speer | Physical Therapy Assistant | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2016-01-27 |
| 1285009472 | Sharon Broberg | Occupational Therapy Assistant | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2015-12-14 |
| 1346626678 | Dana Montgomery | Speech-Language Pathologist | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2015-08-10 |
| 1922481621 | Stacey Pestar | Physical Therapy Assistant | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2015-06-30 |
| 1497147763 | Lookout Post Acute, LLC | Skilled Nursing Facility | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2015-02-24 |
| 1083005219 | Mae L Crawford | Physical Therapy Assistant | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2015-02-10 |
| 1629493416 | Annushka Cesan | Nurse Practitioner | 300 S 18th St, Mount Vernon, WA 98274-4661 | 2014-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123438 | Ankur Tarun Sanghvi | Peer Specialist | 209 Milwaukee Steet, 209, Mount Vernon, WA 98274 | 2017-06-07 |
| 1932647187 | Claudia Diaz | Counselor | 23550 Garden St, Mount Vernon, WA 98274 | 2017-02-08 |
| 1871042002 | Richard Simcock Dds, Ps | Dentist | 130 S 15th St Suite 101, Mount Vernon, WA 98274 | 2016-09-29 |
| 1528228186 | Parampreet Singh Ghuman | Internal Medicine | 121 S. 12th St, Ste B, Mount Vernon, WA 98274 | 2008-06-16 |
| 1699940874 | Eugene Villanueva De Guzman | Internal Medicine | 208 S Hospital Pkwy, Mount Vernon, WA 98274 | 2008-04-28 |
| 1871775122 | Matthew John Novak | Internal Medicine | 208 Hospital Pkwy, Mount Vernon, WA 98274 | 2007-11-28 |
| 1568658797 | Emily A K Bianconi | Nurse Practitioner | 2101 Little Mountain Lane, Mount Vernon, WA 98274 | 2007-09-21 |
| 1659576981 | Peggy Randall | Counselor | 1420 S 12th, Mount Vernon, WA 98274 | 2007-06-18 |
| 1194937037 | Cascade Neurologic Clinic, Inc, P.s. | Clinic/Center | 1315 East Division St., Mt. Vernon, WA 98274 | 2007-05-04 |
| 1427171297 | Keri L D Halgren | Dentist | 1711 E Division Street, Mt Vernon, WA 98274 | 2007-04-09 |
| Find all providers in zip 98274 | ||||
| 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 |
|---|---|---|---|---|
| 1275056491 | Als Mount Vernon Inc | Skilled Nursing Facility | 1135 Gambier Rd, Mount Vernon, OH 43050-3839 | 2017-07-19 |
| 1679029110 | Tameka Bremmer | Skilled Nursing Facility | 171 W Kingsbridge Rd, 3rd Fl, Mount Vernon, NY 10550-4831 | 2016-08-25 |
| 1982813341 | Missouri Veterans Commission | Skilled Nursing Facility | 1600 S Hickory St, Mount Vernon, MO 65712-2045 | 2007-05-22 |
| 1689795379 | Ssc Mount Vernon Operating Company LLC | Skilled Nursing Facility | 1001 S 34th St, Mount Vernon, IL 62864-6232 | 2007-04-02 |
| 1598831869 | Mount Vernon Elderly Services LLC | Skilled Nursing Facility | 1350 Yauger Rd, Mount Vernon, OH 43050-9233 | 2006-11-28 |
| 1053483818 | Indiana Health and Rehabilitation Centers | Skilled Nursing Facility | 1415 Country Club Rd, Mount Vernon, IN 47620-9301 | 2006-11-15 |
| 1841374238 | Mt Vernon Nursing Home Inc | Skilled Nursing Facility | 501 Yates St, Mount Vernon, TX 75457-3233 | 2006-10-24 |
| 1558301812 | Tandem Health Care of Mt. Vernon, Inc. | Skilled Nursing Facility | 416 Wooster Rd, Mount Vernon, OH 43050-1216 | 2006-06-07 |
| 1861440174 | Westchester Center for Rehabilitation and Nursing | Skilled Nursing Facility | 10 Claremont Ave, Mount Vernon, NY 10550-1609 | 2006-05-05 |
| 1104887561 | Lawrence County Nursing Home District | Skilled Nursing Facility | 915 Carl Allen St, Mount Vernon, MO 65712-1612 | 2006-03-28 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 98274 |
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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.