REDWOOD LTC GROUP, LLC (NPI# 1962447565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962447565 |
| Entity Type | Organization |
| Organization Name | REDWOOD LTC GROUP, LLC |
| Other Organization Name | PREMIER NURSING AND REHABILITATION CENTER |
| Practice Address |
225 White St Jacksonville NC 28546-6351 |
| Practice Telephone | 9103537222 |
| Practice Fax Number | 9103538010 |
| Mailing Telephone | 9103537222 |
| Mailing Fax Number | 9103538010 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | MS. KAREN G MCDANIEL (PRESIDENT) |
| Authorized Official Telephone | 2525239094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH0229 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7802298 | 05 | |
| NC | 3405217 | 05 | |
| NC | BC/BS OF NC | 00959 | 01 |
| NC | 3415217 | 05 | |
| NC | STATE HEALTH PLAN # | 00959 | 01 |
| Other Name | Type Code |
|---|---|
| Premier Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285665539 | Redwood Ltc Group, LLC | Skilled Nursing Facility | 604 Lucas Rd, Dunn, NC 28334-6623 | 2006-07-05 |
| 1396771515 | Redwood Ltc Group, LLC | Skilled Nursing Facility | 3015 Enterprise Dr, Wilmington, NC 28405-2116 | 2006-06-23 |
| 1932145836 | Redwood Ltc Group, LLC | Skilled Nursing Facility | 312 Warren Ave, Kinston, NC 28501-3840 | 2006-06-21 |
| Street Address |
225 WHITE ST |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639722077 | Caylene Tripp | Occupational Therapist | 225 White St, Jacksonville, NC 28546-6351 | 2019-07-23 |
| 1831752294 | Angela L Aluise | Speech-Language Pathologist | 225 White St, Jacksonville, NC 28546-6351 | 2019-04-20 |
| 1386111722 | Lakasha Akisha Wright | Nurse Practitioner | 225 White St, Jacksonville, NC 28546-6351 | 2018-10-24 |
| 1235610437 | Rosa Grayer | Physical Therapist | 225 White St, Jacksonville, NC 28546-6351 | 2018-08-25 |
| 1821578519 | Alex Slominski | Physical Therapist | 225 White St, Jacksonville, NC 28546-6351 | 2018-08-21 |
| 1811476443 | Kerri Elizabeth Wright | Occupational Therapist | 225 White St, Jacksonville, NC 28546-6351 | 2018-08-14 |
| 1205315256 | Sarah Burnett | Speech-Language Pathologist | 225 White St, Jacksonville, NC 28546-6351 | 2018-08-10 |
| 1437638855 | Angela Macumber | Speech-Language Pathologist | 225 White St, Jacksonville, NC 28546-6351 | 2018-08-07 |
| 1942457213 | Gleny Grace Martinez | Physical Therapist | 225 White St, Jacksonville, NC 28546-6351 | 2008-08-19 |
| 1043473648 | Nicole Summerlin | Physical Therapy Assistant | 225 White St, Jacksonville, NC 28546-6351 | 2008-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| 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 |
|---|---|---|---|---|
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1629439260 | West Jax Geriatrics, LLC | Skilled Nursing Facility | 730 College St, Jacksonville, FL 32204-3313 | 2016-03-10 |
| 1376955377 | Edwin Bato | Skilled Nursing Facility | 3434 Nightscape Cir, Jacksonville, FL 32224-1618 | 2014-05-24 |
| 1508138678 | Terri Velinda Virgil | Skilled Nursing Facility | 11555 Birch Forest Circle East, Jacksonville, FL 32218 | 2012-02-03 |
| 1689993032 | Jacksonville Scc, LLC | Skilled Nursing Facility | 810 Bellaire St, Jacksonville, TX 75766-9045 | 2010-05-25 |
| 1326362005 | Brooks Skilled Nursing Facility, A, Inc. | Skilled Nursing Facility | 6209 Brooks Bartram Dr. Bldg 100, Jacksonville, FL 32258 | 2010-03-24 |
| 1144476946 | Magnus Opus Technology | Skilled Nursing Facility | 7000 Northlake Dr, Jacksonville, AR 72076-4959 | 2008-08-12 |
| 1972796175 | Russell Wayne Tolliver | Skilled Nursing Facility | 4083 Sunbeam Rd, Apartment 1409, Jacksonville, FL 32257-8993 | 2007-08-21 |
| 1750409082 | Patti Sperling Arnp LLC | Skilled Nursing Facility | 402 Myrtlewood Cir, Jacksonville, NC 28546-7412 | 2007-03-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on REDWOOD LTC GROUP, LLC.
| 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.