MEDICAL MANAGEMENT OF MACON, INC. (NPI# 1962437517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962437517 |
| Entity Type | Organization |
| Organization Name | MEDICAL MANAGEMENT OF MACON, INC. |
| Practice Address |
29612 Kellogg Ave Macon MO 63552-3702 |
| Practice Telephone | 6603855797 |
| Mailing Telephone | 6603855797 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STUART YACHNOWITZ (PRESIDENT) |
| Authorized Official Telephone | 5163714000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 031177 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BC BS | 30164 | 01 |
| Street Address |
29612 KELLOGG AVE |
| City | MACON |
| State | MO |
| Zip Code | 63552-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215238589 | Nhc Healthcare-macon LLC | Skilled Nursing Facility | 29612 Kellogg Ave, Macon, MO 63552-3702 | 2010-11-03 |
| 1700045465 | Kirsten Renae Simms | Occupational Therapist | 29612 Kellogg Ave, Macon, MO 63552-3702 | 2008-06-06 |
| 1558554592 | Karyn Leslie Walters | Physical Therapy Assistant | 29612 Kellogg Ave, Macon, MO 63552-3702 | 2007-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891194783 | Dialysis Clinic Inc | Clinic/Center | 1203 N. Missouri St, Macon, MO 63552 | 2014-08-18 |
| 1477624161 | Charles Edgar Averill Jr. | Occupational Therapist | 704a South Missouri, Macon, MO 63552 | 2006-11-13 |
| 1629035084 | Missouri Cvs Pharmacy, L.L.C. | Pharmacy | 1105 N Rutherford St, Macon, MO 63552 | 2006-04-28 |
| 1659560688 | Iris Ladawn Gaerditz | Speech-Language Pathologist | 702 N Missouri St, Macon, MO 63552 | 2007-10-16 |
| 1841316296 | Paul Vincent Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-03-21 |
| 1891908612 | Mid Missouri Physical Therapy | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0381 | 2007-05-08 |
| 1366568735 | Lara Beth Jones | Physical Therapist | 2005 N. Missouri St., Suite D., Macon, MO 63552-0381 | 2007-03-21 |
| 1871619262 | Abby M Lane | Physical Therapist | 2005 N. Missouri St., Suite D, Macon, MO 63552-0387 | 2007-03-21 |
| 1457715906 | Kimberly Oroke | Social Worker | 821 Charles St, Columbia, MO 63552-1064 | 2016-04-11 |
| 1679100507 | Macon County Sheltered Workshop | Private Vehicle | 1103 Enterprise Rd, Macon, MO 63552-1305 | 2020-03-23 |
| Find all providers in zip 63552 | ||||
| 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 |
|---|---|---|---|---|
| 1013321884 | Pruitthealth - Eastside, LLC | Skilled Nursing Facility | 2795 Finney Cir, Macon, GA 31217-4512 | 2014-06-19 |
| 1982963682 | Zebulon Park Health and Rehabilitation LLC | Skilled Nursing Facility | 343 Plantation Way, Macon, GA 31210 | 2012-05-15 |
| 1306060439 | Middle Georgia Life Care Inc. | Skilled Nursing Facility | 400 Foster Road, Macon, GA 31210 | 2007-04-12 |
| 1740341312 | Porter Field Health & Rehab Center LLC | Skilled Nursing Facility | 3051 Whiteside Rd, Macon, GA 31216-6209 | 2006-12-13 |
| 1649340167 | Goodwill Nursing Home, Inc | Skilled Nursing Facility | 4373 Houston Ave, Macon, GA 31206-2760 | 2006-11-09 |
| 1992741995 | Monroe County Nursing Home LLC | Skilled Nursing Facility | 529 Bolingreen Dr, Macon, GA 31210-5303 | 2006-06-20 |
| 1487699831 | Bibb County Health Care LLC | Skilled Nursing Facility | 3468 Napier Ave, Macon, GA 31204-3743 | 2006-06-19 |
| 1740227164 | Cherry Blossom Health Care Center LLC | Skilled Nursing Facility | 3520 Kenneth Dr, Macon, GA 31206-3824 | 2006-06-02 |
| 1093762510 | Pruitthealth - Peake, LLC | Skilled Nursing Facility | 6190 Peake Rd, Macon, GA 31220-3956 | 2006-05-29 |
| 1710934237 | Pruitthealth - Macon, LLC | Skilled Nursing Facility | 2255 Anthony Rd, Macon, GA 31204-5823 | 2006-05-29 |
| Find all providers in MACON | ||||
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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.