SUPPLEMENTAL HEALTHCARE (NPI# 1831625037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831625037 |
| Entity Type | Organization |
| Organization Name | SUPPLEMENTAL HEALTHCARE |
| Practice Address |
319 Vancouver Drive Apartment 38g Fayetteville NC 28303 |
| Mailing Address |
319 Vancouver Dr Apartment 38g Fayetteville NC 28303-5785 |
| Practice Telephone | 3474471868 |
| Mailing Telephone | 3474471868 |
| Enumeration Date | 2017-05-08 |
| Last Update Date | 2017-05-08 |
| Authorized Official Name | CHERRELLE HARVIN (RECRUITING COORDINATOR) |
| Authorized Official Telephone | 9844449903 |
| 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 |
|---|---|---|---|
| NC | 1 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477981199 | Supplemental Healthcare | Nursing Facility/Intermediate Care Facility | 200 Tulip Tree Ct, Easley, SC 29642-7600 | 2013-10-15 |
| 1376837922 | Supplemental Healthcare | Case Management | 4620 N Braeswood Blvd Apt 52, Houston, TX 77096-2847 | 2011-05-31 |
| 1871899302 | Supplemental Healthcare | Skilled Nursing Facility | 9029 E Mississippi Ave Apt R302, Denver, CO 80247-6867 | 2011-01-31 |
| 1376788166 | Supplemental Healthcare | Rehabilitation Hospital | 333 Gellert Blvd Ste 150, Daly City, CA 94015-2690 | 2008-12-08 |
| 1144409640 | Supplemental Healthcare | Home Health | 6033 Brookgreen Ct, Spartanburg, SC 29301-3547 | 2007-10-31 |
| 1982745022 | Supplemental Healthcare | General Acute Care Hospital | 3040 Post Oak Blvd, Suite 1200, Houston, TX 77056-6500 | 2007-02-10 |
| 1619377785 | Supplemental Healthcare | Occupational Therapy Assistant | 7320 Sw Hunziker St Ste 203, Tigard, OR 97223-2301 | 2014-08-26 |
| 1427489723 | Supplemental Healthcare | Local Education Agency (LEA) | 551 5th Ave, Suite 1923, New York, NY 10176-0001 | 2013-12-11 |
| 1407281140 | Supplemental Healthcare | General Acute Care Hospital | 6500 Rockside Rd, Ste. 240, Independence, OH 44131-2368 | 2013-09-12 |
| 1902145766 | Supplemental Healthcare | Rehabilitation Hospital | 4720 E Cotton Gin Loop, Phoenix, AZ 85040-4823 | 2013-02-13 |
| Street Address |
319 VANCOUVER DRIVE APARTMENT 38G |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| 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 |
|---|---|---|---|---|
| 1659764447 | Kathleen Mason | Skilled Nursing Facility | 13 Lorelei Dr, Fayetteville, OH 45118-8404 | 2015-03-18 |
| 1083917413 | Autumn Corporation | Skilled Nursing Facility | 1401 71st School Rd, Fayetteville, NC 28314-2814 | 2010-12-07 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1962674796 | Tison Speech Therapy Services | Skilled Nursing Facility | 1387 N Bernice Dr, Fayetteville, AR 72703-6086 | 2008-04-01 |
| 1851443022 | Washington Regional Medicorp, Inc. | Skilled Nursing Facility | 221 S School Ave, Fayetteville, AR 72701-5969 | 2007-01-17 |
| 1871659730 | Fayette Nursing & Rehabilitation Center LLC | Skilled Nursing Facility | 100 Hresan Blvd, Fayetteville, WV 25840-1333 | 2006-12-28 |
| 1740368612 | Lafayette Health Care Center, Inc. | Skilled Nursing Facility | 110 Brandywine Blvd, Fayetteville, GA 30214-1500 | 2006-11-01 |
| 1417052895 | State of Arkansas | Skilled Nursing Facility | 1179 N. College Avenue, Fayetteville, AR 72703 | 2006-09-13 |
| 1699886085 | Highland House of Fayetteville, Inc | Skilled Nursing Facility | 1700 Pamalee Dr, Fayetteville, NC 28301-2824 | 2006-08-31 |
| 1487760765 | Piney Partners Lp | Skilled Nursing Facility | 6375 Chambersburg Rd, Fayetteville, PA 17222-8350 | 2006-08-21 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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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.