SUNBRIDGE RETIREMENT CARE ASSOCIATES, LLC (NPI# 1659321446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659321446 |
| Entity Type | Organization |
| Organization Name | SUNBRIDGE RETIREMENT CARE ASSOCIATES, LLC |
| Other Organization Name | RENAISSANCE CARE AND REHABILITATION CENTER |
| Practice Address |
415 Airport Rd Griffin GA 30224-4834 |
| Mailing Address |
101 Sun Ave Ne Compliance Department Albuquerque NM 87109-4373 |
| Practice Telephone | 7702278636 |
| Practice Fax Number | 7702274754 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-02-01 |
| Authorized Official Name | WILLIAM A. MATHIES (PRESIDENT DIRECTOR) |
| Authorized Official Telephone | 5058213355 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUNBRIDGE HEALTHCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 11261356 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00141754A | 05 |
| Other Name | Type Code |
|---|---|
| Renaissance Care and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174574164 | Sunbridge Retirement Care Associates, LLC | Skilled Nursing Facility | 5131 Warm Springs Rd, Columbus, GA 31909-4196 | 2006-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SunBridge Retirement Care Associates, LLC | 101 E. State Street, Kennett Square, PA 19348 |
| Street Address |
415 AIRPORT RD |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30224-4834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063062412 | Airport Road Healthcare LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-18 |
| 1124678651 | Airport Road Realty LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-17 |
| 1144887720 | Pai Participant 11 PC | Internal Medicine | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-05-20 |
| 1396250890 | Dalton James Skipper | Nurse Practitioner | 415 Airport Rd, Griffin, GA 30224-4834 | 2017-12-06 |
| 1972039261 | Christie Thomas | Occupational Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2017-05-04 |
| 1699191452 | Genesis Eldercare Physician Services LLC | Internal Medicine | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-03-17 |
| 1730504515 | Deborah Husser | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-03-03 |
| 1427473735 | Yolanda Gwathmey | Physical Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-02-24 |
| 1003231317 | Launce Braddock | Occupational Therapy Assistant | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-02-24 |
| 1194972661 | Stacy Williams | Speech-Language Pathologist | 415 Airport Rd, Griffin, GA 30224-4834 | 2008-08-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346888971 | Latamika Renee Williams | Counselor | 1710 Ga-16 West, #6, Griffin, GA 30224 | 2019-12-13 |
| 1063062651 | Dominique S Paul-thompson | Contractor | 112 Deercreek Parkway, Griffin, GA 30224 | 2019-09-16 |
| 1497303531 | Xiaohui Zhang Brotzge | Physician Assistant | 601 S 8th Street, Griffin, GA 30224 | 2019-09-02 |
| 1548812282 | Andrew Dennis Nesmith | Registered Nurse | 601 South 8th St, Emergency Room, Griffin, GA 30224 | 2019-07-12 |
| 1073009122 | Alicia Skye Ledford | Nurse Practitioner | 619 S 8th St., Suite 200, Griffin, GA 30224 | 2018-07-02 |
| 1649787102 | Judith Fuajong Ngulefac | Nurse Practitioner | 1705 Williamson Rd, Griffin, GA 30224 | 2018-01-05 |
| 1699297077 | Amanda Norman | Speech-Language Pathologist | 106 Garnet Ln, Griffin, GA 30224 | 2017-07-07 |
| 1306214655 | Ruchi P Gandhi | Optometrist | 646 8th Street, Griffin, GA 30224 | 2015-09-03 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1437436094 | C. B. Reddy Md PC | Preferred Provider Organization | 610 S 8th Street, Suite F, Griffin, GA 30224 | 2011-11-10 |
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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 |
|---|---|---|---|---|
| 1447207964 | Pruitthealth - Griffin, LLC | Skilled Nursing Facility | 619 Northside Dr, Griffin, GA 30223-1402 | 2006-05-29 |
| 1093702565 | Brightmoor Health Care Inc | Skilled Nursing Facility | 3235 Newnan Rd, Griffin, GA 30223-7114 | 2005-09-30 |
| 1063062412 | Airport Road Healthcare LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-18 |
| 1124678651 | Airport Road Realty LLC | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2019-09-17 |
| 1730504515 | Deborah Husser | Skilled Nursing Facility | 415 Airport Rd, Griffin, GA 30224-4834 | 2014-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281982 | Georgia Regional Health Services LLC | Skilled Nursing Facility | 3731 Lake Pass Ln, Suwanee, GA 30024-8422 | 2020-09-30 |
| 1124633268 | Lavender Mountain Senior Living Inc | Skilled Nursing Facility | 600 Eagle Lake Trl, Rome, GA 30165-2207 | 2020-09-15 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1205486859 | Magnolia Manor of Liberty County, Inc. | Skilled Nursing Facility | 625 N Coastal Hwy # 17, Midway, GA 31320-3433 | 2019-09-16 |
| 1497301170 | Prestige Health Services LLC | Skilled Nursing Facility | 1770 Indian Trail Lilburn Rd Ste 420, Norcross, GA 30093-2644 | 2019-08-17 |
| 1043878721 | Keysville Ltc Management LLC | Skilled Nursing Facility | 1005 Ga Highway 88, Blythe, GA 30805-3911 | 2019-05-29 |
| 1689131724 | Favor Home Health Care Services, LLC | Skilled Nursing Facility | 51 Gallery Ct, Acworth, GA 30101-2709 | 2019-02-25 |
| 1104398866 | University Extended Care, Inc | Skilled Nursing Facility | 1005 Highway 88 N, Keysville, GA 30816 | 2018-12-19 |
| 1548745342 | Gacalhoun Snf LLC | Skilled Nursing Facility | 1387 Highway 41 N., Calhoun, GA 30701 | 2018-09-27 |
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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.