PROMEDICA MONROE SKILLED NURSING AND REHAB (NPI# 1801996210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801996210 |
| Entity Type | Organization |
| Organization Name | PROMEDICA MONROE SKILLED NURSING AND REHAB |
| Practice Address |
700 Stewart Rd Monroe MI 48162-5304 |
| Mailing Address |
333 N Summit St Toledo OH 43604-2615 |
| Practice Telephone | 7342401820 |
| Practice Fax Number | 7342401896 |
| Mailing Telephone | 1925255004 |
| Mailing Fax Number | 8004803780 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-02-19 |
| Authorized Official Name | MARTIN DAVID ALLEN (DIRECTOR) |
| Authorized Official Telephone | 4192525734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2808950 | 05 | |
| MI | BLUE CROSS | 09518 | 01 |
| MI | AETNA | 4432019 | 01 |
| Other Name | Type Code |
|---|---|
| MERCY MEMORIAL NURSING CENTER | Doing Business As Name - Organization |
| Street Address |
700 STEWART RD |
| City | MONROE |
| State | MI |
| Zip Code | 48162-5304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760014484 | Rachel Berky Johnson | Speech-Language Pathologist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2020-02-11 |
| 1760037808 | Pamudu Dissanayake | Occupational Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2019-08-06 |
| 1003471335 | Katelyn E Grau | Physical Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2019-05-02 |
| 1861963316 | Paige Wittler | Speech-Language Pathologist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2018-12-10 |
| 1356848972 | Dawn Marie Foshag | Occupational Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2018-04-10 |
| 1013413939 | Brian Carmona | Occupational Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2018-03-30 |
| 1760984876 | Christina Danford Parker | Speech-Language Pathologist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2018-03-05 |
| 1417460361 | Elishia Kay Sutter | Physical Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2017-11-14 |
| 1326581760 | Marianne Strzelecki | Occupational Therapist | 700 Stewart Rd, Monroe, MI 48162-5304 | 2016-12-01 |
| 1386095966 | Jasmine Marie Eddins | Occupational Therapy Assistant | 700 Stewart Rd, Monroe, MI 48162-5304 | 2016-06-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568016012 | Silke A Goudos | Nurse Practitioner | 730 N Macomb Street #200, Monroe, MI 48162 | 2019-08-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1740769702 | Carissa Pollock | Behavioral Analyst | 2086 S. Custer Rd., Monroe, MI 48162 | 2018-08-10 |
| 1710488440 | Stacy Michael Lucio | Nurse Practitioner | 901 N Macomb St Ste 109, Monroe, MI 48162 | 2018-02-27 |
| 1407239882 | Lisa Gilbert Peleman | Student in an Organized Health Care Education/Training Program | Promedica Monroe Regional Hospital Family Medicine Res, 650 Stewart Rd, Monroe, MI 48162 | 2015-07-03 |
| 1427430552 | Cheryl Fosgate | Counselor | 4350 N Monroe St, Monroe, MI 48162 | 2015-06-25 |
| 1538551460 | Convenient Mr PC | Dentist | 7500 N. Telegraph Rd., Monroe, MI 48162 | 2015-03-02 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1073872743 | Justin L Chamberlain | Surgery | 730 N Macomb St Ste 329, Monroe, MI 48162 | 2012-05-15 |
| 1639462674 | Toledo Clinic Incorporated | Durable Medical Equipment & Medical Supplies | 800 Stewart Road, Suite B, Monroe, MI 48162 | 2011-05-24 |
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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 |
|---|---|---|---|---|
| 1992106348 | The Heritage of Union County, LLC | Skilled Nursing Facility | 3510 W Highway 74, Monroe, NC 28110-8441 | 2014-09-04 |
| 1245514546 | Riverside Nursing Home, LLC | Skilled Nursing Facility | 7950 Millhaven Road, Monroe, LA 71203-9008 | 2011-10-05 |
| 1295990836 | Marci Gail Milne | Skilled Nursing Facility | 3006 Dewdrop Ct, Monroe, NC 28110-6346 | 2008-07-23 |
| 1821265638 | Ida Lyn Stevenson | Skilled Nursing Facility | 2903 13th St, Monroe, WI 53566-2245 | 2008-05-12 |
| 1467657304 | Northeast Louisana Veterans Home | Skilled Nursing Facility | 6700 Highway 165 N, Monroe, LA 71203-8753 | 2007-06-20 |
| 1023180734 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 516 26th Ave, Monroe, WI 53566-1531 | 2006-11-15 |
| 1033207121 | Management Company Inc | Skilled Nursing Facility | 4201 S Grand St, Monroe, LA 71202-6319 | 2006-10-11 |
| 1396754750 | Avalon Place, Lp | Skilled Nursing Facility | 4385 Old Sterlington Rd, Monroe, LA 71203-2360 | 2006-08-05 |
| 1912931254 | Woodlawn Manor, Inc. | Skilled Nursing Facility | 1000 Mckeen Pl, Monroe, LA 71201 | 2006-07-11 |
| 1548205255 | Beach Nursing Home Inc. | Skilled Nursing Facility | 1215 N Telegraph Rd, Monroe, MI 48162-3368 | 2006-06-17 |
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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.