TAR RIVER LTC GROUP, LLC (NPI# 1750317897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750317897 |
| Entity Type | Organization |
| Organization Name | TAR RIVER LTC GROUP, LLC |
| Other Organization Name | RIVER TRACE NURSING AND REHABILITATION CENTER |
| Practice Address |
250 Lovers Ln Washington NC 27889-3436 |
| Mailing Address |
Po Box 398 Washington NC 27889-0398 |
| Practice Telephone | 2529751636 |
| Practice Fax Number | 2529755960 |
| Mailing Telephone | 2529751636 |
| Mailing Fax Number | 2529755960 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | MS. KAREN G MCDANIEL (PRESIDENT) |
| Authorized Official Telephone | 2525239094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH0345 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3425215 | 05 | |
| NC | BC/BS OF NC | 0089L | 01 |
| NC | MEDICAID ADULT CARE # | 7801167 | 01 |
| NC | 3415215 | 05 |
| Other Name | Type Code |
|---|---|
| River Trace Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285660787 | Tar River Ltc Group, LLC | Respite Care | 1084 Us Highway 64 E, Plymouth, NC 27962-9215 | 2006-06-25 |
| 1992741391 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 119 Gatlin St, Williamston, NC 27892-2560 | 2006-06-22 |
| 1770529141 | Tar River Ltc Group, LLC | Custodial Care Facility | 3210 Western Blvd, Tarboro, NC 27886-1828 | 2006-06-22 |
| 1356386445 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 430 W Health Center Dr, Nags Head, NC 27959-8943 | 2006-06-20 |
| 1083659692 | Tar River Ltc Group, LLC | Clinic/Center | 1341 Paradise Rd, Edenton, NC 27932-8503 | 2006-06-18 |
| 1013951896 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 200 Hampton Woods Complex, Jackson, NC 27845-9503 | 2006-06-15 |
| 1184809279 | Tar River Ltc Group, LLC | Nursing Facility/Intermediate Care Facility | 1084 Us Highway 64 E, Plymouth, NC 27962-9215 | 2008-01-08 |
| Street Address |
250 LOVERS LN |
| City | WASHINGTON |
| State | NC |
| Zip Code | 27889-3436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609426212 | Savannah Mumford Vick | Occupational Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2019-09-16 |
| 1669030201 | Chelsie K Brown | Physical Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2019-05-29 |
| 1780159202 | Andrea Allgeier Drake | Occupational Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2018-10-11 |
| 1669954079 | Elizabeth Arnold | Physical Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2018-08-31 |
| 1386126142 | Elizabeth Sheehan Allen | Occupational Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2018-08-29 |
| 1962984740 | Mary Pleasants | Physical Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2018-08-29 |
| 1881841203 | Joan Brown | Occupational Therapy Assistant | 250 Lovers Ln, Washington, NC 27889-3436 | 2008-08-27 |
| 1538316393 | Tammy Smith | Physical Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2008-08-24 |
| 1639326499 | Lori Jefferson | Occupational Therapy Assistant | 250 Lovers Ln, Washington, NC 27889-3436 | 2008-08-24 |
| 1366699126 | Valerie Roberts Starkie | Occupational Therapist | 250 Lovers Ln, Washington, NC 27889-3436 | 2008-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336786326 | Coastal Solutions LLC | Counselor | 51 Hwy 33 W, Chocowinity, NC 27889 | 2019-12-09 |
| 1952946246 | Emily Hodges Hall | Pharmacy | 627 E 12th Street, Washington, NC 27889 | 2019-11-11 |
| 1649780032 | John Bailey Bland II | Chiropractor | 610 W. 15th. St., Washington, NC 27889 | 2017-10-11 |
| 1255780136 | County of Beaufort | Ambulance | 1420 Highland Drive, Washington, NC 27889 | 2016-06-10 |
| 1790175917 | Inner Coastal Orthotics and Prosthetics | Orthotist | 1102 North Brown St., Washington, NC 27889 | 2015-01-26 |
| 1972847390 | Country Living Guest Home #7 | Community/Behavioral Health | 207 W 11th St, Washington, NC 27889 | 2012-11-26 |
| 1104182005 | Country Living Guest Home #8 | Community/Behavioral Health | 618 Plant St, Washington, NC 27889 | 2012-04-04 |
| 1881986537 | Mary Lewis Scarbraugh | Social Worker | 408 E. 11th St., Washington, NC 27889 | 2011-05-12 |
| 1952615825 | Country Living Guest Home #6 | Community/Behavioral Health | 252 Dan Taylor Rd, Washington, NC 27889 | 2010-08-03 |
| 1376784371 | Jennifer Michele Richardson | Nurse Practitioner | 1207 Highland Drive, Washington, NC 27889 | 2009-03-20 |
| Find all providers in zip 27889 | ||||
| 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 |
|---|---|---|---|---|
| 1841688298 | Daviess County Hospital | Skilled Nursing Facility | 1694 Troy Rd, Washington, IN 47501-8211 | 2015-01-07 |
| 1891124103 | Jamie Lilley | Skilled Nursing Facility | 1734 John Small Ave, Washington, NC 27889-7387 | 2013-11-06 |
| 1396010781 | Supplemental Health Care | Skilled Nursing Facility | 1759 W 5th St, Washington, NC 27889-4003 | 2012-03-19 |
| 1558657114 | Kyle Lee Decker | Skilled Nursing Facility | 504 E Telegraph St Unit 81, Washington, UT 84780-8851 | 2011-06-22 |
| 1063710812 | Eban Health Services Inc | Skilled Nursing Facility | 3502 18th St.. Ne, Suite 1, Washington, DC 20018 | 2011-03-03 |
| 1619136025 | Peoplefirst | Skilled Nursing Facility | 250 Lovers Lane, Washington, NC 27889 | 2008-06-02 |
| 1093983827 | Rock Creek Nursing Center Inc | Skilled Nursing Facility | 2131 O St Nw, Washington, DC 20037-1008 | 2008-02-14 |
| 1275713463 | The Medilodge Group, Inc. | Skilled Nursing Facility | 64500 Van Dyke Rd, Washington, MI 48095-2583 | 2007-11-06 |
| 1962559104 | Stoddard Baptist Home | Skilled Nursing Facility | 1818 Newton St Nw, Washington, DC 20010-1017 | 2007-01-03 |
| 1316005069 | Jb Johnson Nursing Center | Skilled Nursing Facility | 901 1st St Nw, Washington, DC 20001-1403 | 2006-12-05 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 27889 |
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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.