WHITE RIVER LODGE, LTD (NPI# 1922218031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922218031 |
| Entity Type | Organization |
| Organization Name | WHITE RIVER LODGE, LTD |
| Practice Address |
3710 Kenny Simpson Ln Bedford IN 47421-5632 |
| Practice Telephone | 8122757006 |
| Mailing Telephone | 8122757006 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-01-06 |
| Authorized Official Name | BRENDA PREMO (ADMINISTRATOR) |
| Authorized Official Telephone | 8122757006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 4843 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200155900A | 05 |
| Street Address |
3710 KENNY SIMPSON LN |
| City | BEDFORD |
| State | IN |
| Zip Code | 47421-5632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205398740 | Melissa Sojka | Occupational Therapy Assistant | 3710 Kenny Simpson Ln, Bedford, IN 47421-5632 | 2019-04-03 |
| 1609136159 | Rush Memorial Hospital | Skilled Nursing Facility | 3710 Kenny Simpson Ln, Bedford, IN 47421-5632 | 2012-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114406303 | Leana Michelle Massimini | Speech-Language Pathologist | 3710 Kenneth Simpson Ln, Bedford, IN 47421 | 2018-08-09 |
| 1497246888 | Sara Lehr Corry | Counselor | 2325 Q St., Bedford, IN 47421 | 2018-05-22 |
| 1760737274 | Lisa Lynne Autry | Social Worker | 2125 16th Street, Bedford, IN 47421 | 2012-07-20 |
| 1285998153 | Reid Clipp Crosby | Obstetrics & Gynecology | 118woodhill Dr, Bedford, IN 47421 | 2012-06-26 |
| 1730453184 | Fields Chiropractic Inc | Chiropractor | 2418 W 16th St, Bedford, IN 47421 | 2012-03-02 |
| 1639461783 | Lori Wininger | Physical Therapy Assistant | 2137 16th Street, Bedford, IN 47421 | 2011-05-09 |
| 1871743716 | Union Optical and Eyecare Center, Inc. | Optometrist | 3343 Michael Ave, Bedford, IN 47421 | 2008-09-29 |
| 1326207176 | Ross Wright | Surgery | 179 Shawswick Road, Bedford, IN 47421 | 2008-06-06 |
| 1336320563 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1510 Clinic Dr, Bedford, IN 47421 | 2007-11-15 |
| 1306031992 | Assisted Living Concepts Inc | Assisted Living Facility | 3008 Shawnee Drive, South Bedford, IN 47421 | 2007-09-07 |
| Find all providers in zip 47421 | ||||
| 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 |
|---|---|---|---|---|
| 1447610977 | Hamilton County Hospital District | Skilled Nursing Facility | 2112 Forum Pkwy, Bedford, TX 76021-6028 | 2016-02-25 |
| 1336320563 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1510 Clinic Dr, Bedford, IN 47421 | 2007-11-15 |
| 1295882272 | Major Hospital | Skilled Nursing Facility | 514 16th St, Bedford, IN 47421-3817 | 2007-01-04 |
| 1922183086 | Jackson County Schneck Memorial Hospital | Skilled Nursing Facility | 3100 S Shawnee Dr, Bedford, IN 47421-5287 | 2006-10-26 |
| 1396820890 | La Dora Management, Inc. | Skilled Nursing Facility | 1960 Bedford Rd, Bedford, TX 76021-5722 | 2006-10-25 |
| 1295768273 | Harborside New Hampshire Limited Partnership | Skilled Nursing Facility | 30 Colby Ct, Bedford, NH 03110-6426 | 2006-07-10 |
| 1720020399 | Mckerley Health Care Centers, Inc. | Skilled Nursing Facility | 480 Donald St, Bedford, NH 03110-5945 | 2006-06-11 |
| 1881649242 | Donahoe Manor-bedford Pa LLC | Skilled Nursing Facility | 136 Donahoe Manor Rd, Bedford, PA 15522-9728 | 2006-05-24 |
| 1568432466 | Care Initiatives | Skilled Nursing Facility | 1005 Pearl St, Bedford, IA 50833-1276 | 2006-01-24 |
| 1629057138 | Hqm of Trimble County, Inc. | Skilled Nursing Facility | 50 Shepherd Ln, Trimble County, Bedford, KY 40006-8809 | 2006-01-12 |
| Find all providers in BEDFORD | ||||
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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.