THE WATERS OF PRINCETON, LLC (NPI# 1871531459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871531459 |
Entity Type | Organization |
Organization Name | THE WATERS OF PRINCETON, LLC |
Practice Address |
1020 W Vine St Princeton IN 47670-1164 |
Practice Telephone | 8123855238 |
Practice Fax Number | 8123867471 |
Mailing Telephone | 8123855238 |
Mailing Fax Number | 8123867471 |
Enumeration Date | 2006-06-03 |
Last Update Date | 2012-05-17 |
Authorized Official Name | MR. MICHAEL BLISKO (CEO) |
Authorized Official Telephone | 7084491900 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | 05-000175-1 | IN | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM ST | 000000476417 | 01 |
IN | ANTHEM PT | 000000476418 | 01 |
IN | ANTHEM BCBS | 000000381545 | 01 |
IN | 100274440C | 05 | |
IN | ANTHEM OT | 000000476419 | 01 |
Street Address |
1020 W VINE ST |
City | PRINCETON |
State | IN |
Zip Code | 47670-1164 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972155844 | Megan Lynne Cravens | Occupational Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1199 | 2019-07-11 |
1619212982 | Carol Storckman | Physical Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2012-11-28 |
1205171584 | Natalie Marie Keil | Occupational Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2012-11-28 |
1336484666 | Ashley Brooke Stoelb | Occupational Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2012-11-27 |
1851645782 | Krystal Dawn Campbell | Occupational Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2012-10-30 |
1164782942 | Putnam County Hospital | Skilled Nursing Facility | 1020 W Vine St, Princeton, IN 47670-1164 | 2012-05-25 |
1336452002 | Ellen Chambliss | Physical Therapist | 1020 W Vine St, Princeton, IN 47670-1164 | 2010-07-22 |
1396939344 | Amanda Montell Brashear | Physical Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2007-09-04 |
1700083714 | Andrea Nichole Robling | Occupational Therapy Assistant | 1020 W Vine St, Princeton, IN 47670-1164 | 2007-07-02 |
1760695910 | Healthcare Centers of Indiana, LLC | Skilled Nursing Facility | 1020 W Vine St, Princeton, IN 47670-1164 | 2007-05-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871102384 | Chad Holzmeyer | Pharmacist | 101 W Brumfield Ave., Princeton, IN 47670 | 2020-07-30 |
1497383046 | Jessy Roy Emmett | Hearing Instrument Specialist | 205 West State Street, Suite 1, Princeton, IN 47670 | 2020-03-30 |
1033643010 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 1416 W. Broadway St, Princeton, IN 47670 | 2017-04-17 |
1558782383 | Jon O'keefe | Marriage & Family Therapist | 304 North 5th Avenue, Princeton, IN 47670 | 2013-12-20 |
1376828616 | Andrea Catherine Kohlmeyer | Dietitian, Registered | 2340 E 350 S, Princeton, IN 47670 | 2011-10-19 |
1710192802 | Sarah Ellen Anderson | Pharmacy Technician | 2005 W Broadway, Princeton, IN 47670 | 2007-05-11 |
1760602296 | Buehlers Buy Low Pharmacy | Pharmacy Technician | 2005 W. Broadway, Princeton, IN 47670 | 2007-04-26 |
1114066511 | Jon Robb | Pharmacist | 4924 S Maple Tree Drive, Princeton, IN 47670 | 2007-02-05 |
1558464172 | M S Krishna | Pediatrics | 312 North 3rd Ave, Princeton, IN 47670 | 2006-09-07 |
1255353967 | Gibson County Auditor | Ambulance | 225 N Hart Street, Princeton, IN 47670 | 2006-07-24 |
Find all providers in zip 47670 |
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. |
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1205478286 | Foursquare Texas 16 LLC | Skilled Nursing Facility | 1401 W. Princeton Dr., Princeton, TX 75407 | 2019-10-11 |
1467878512 | Genesis Health Care | Skilled Nursing Facility | 11524 Dawson Road, Princeton, KY 42445 | 2014-03-13 |
1184756173 | Colonial Nursing and Rehabilitation Center | Skilled Nursing Facility | 515 S Bureau Valley Pkwy, Princeton, IL 61356-2203 | 2007-03-12 |
1073688222 | Princeton Nursing Home &rehabilitation Center Inc. | Skilled Nursing Facility | 728 Bunn Dr, Princeton, NJ 08540-1963 | 2006-11-22 |
1467564047 | Good Samaritan Hospital | Skilled Nursing Facility | 1244 Vail St, Princeton, IN 47670-9513 | 2006-08-31 |
1790712206 | Sunnyview Health Care Center Inc. | Skilled Nursing Facility | 900 Sunnyview Ln, Princeton, WI 54968-9262 | 2006-06-28 |
1083692420 | Residential Alternatives of Illinois Inc | Skilled Nursing Facility | 140 N 6th St, Princeton, IL 61356-1878 | 2006-01-05 |
1043291255 | Pearl's II Eden for Elders LLC | Skilled Nursing Facility | 611 N College Ave, Princeton, MO 64673-1051 | 2005-11-07 |
1205824646 | Glenwood Park, Inc. | Skilled Nursing Facility | 1924 Glenwood Park Rd, Princeton, WV 24740-7969 | 2005-10-10 |
1881682680 | Elim Homes, Inc. | Skilled Nursing Facility | 701 1st St, Princeton, MN 55371-1713 | 2005-10-06 |
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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.