EAGLE PEAK LTC GROUP, LLC (NPI# 1972547321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972547321 |
Entity Type | Organization |
Organization Name | EAGLE PEAK LTC GROUP, LLC |
Other Organization Name | KERR LAKE NURSING AND REHABILITATION CENTER |
Practice Address |
1245 Park Ave Henderson NC 27536-4025 |
Mailing Address |
Po Box 1148 Henderson NC 27536-1148 |
Practice Telephone | 2524927021 |
Practice Fax Number | 2524922985 |
Mailing Telephone | 2524927021 |
Mailing Fax Number | 2524922985 |
Enumeration Date | 2006-06-16 |
Last Update Date | 2017-04-07 |
Authorized Official Name | MRS. 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 | NH0353 | NC | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BC/BS OF NC | 0088D | 01 |
NC | 7806629 | 05 | |
NC | 3425321 | 05 | |
NC | 3415321 | 05 |
Other Name | Type Code |
---|---|
Kerr Lake Nursing and Rehabilitation Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376570275 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1704 Nc Hwy 39 North, Louisburg, NC 27549 | 2006-06-27 |
1821024274 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 208 Cary St, Enfield, NC 27823-1204 | 2006-06-25 |
1184650541 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1016 Fletcher St, Wilkesboro, NC 28697-9472 | 2006-06-25 |
1669657755 | Eagle Peak Ltc Group, LLC | Nursing Facility/Intermediate Care Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2008-01-08 |
Street Address |
1245 PARK AVE |
City | HENDERSON |
State | NC |
Zip Code | 27536-4025 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750840245 | Meghan Ealy | Occupational Therapist | 1245 Park Ave, Henderson, NC 27536-4025 | 2019-03-14 |
1992271704 | Katherine Ingram | Speech-Language Pathologist | 1245 Park Ave, Henderson, NC 27536-4025 | 2018-10-18 |
1245711969 | Ashlea Soemo | Speech-Language Pathologist | 1245 Park Ave, Henderson, NC 27536-4025 | 2018-08-22 |
1558849778 | Jessica Combs | Physical Therapy Assistant | 1245 Park Ave, Henderson, NC 27536-4025 | 2018-07-31 |
1578051298 | Mansi Shah | Physical Therapist | 1245 Park Ave, Henderson, NC 27536-4025 | 2018-04-27 |
1669657755 | Eagle Peak Ltc Group, LLC | Nursing Facility/Intermediate Care Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2008-01-08 |
1134316565 | Britthaven, Inc. | Nursing Facility/Intermediate Care Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2007-10-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952940926 | Lane and Associates Xxxvi Dds Pa | Dentist | 900 South Garnett St., Henderson, NC 27536 | 2019-12-23 |
1487012076 | Melissa Burroughs | Registered Nurse | 943-h W. Andrews Avenue, Henderson, NC 27536 | 2016-02-10 |
1578949269 | Growth Recovery Opportunity & Wellness | Community/Behavioral Health | 804 South Garnett St, Henderson, NC 27536 | 2015-08-04 |
1003290297 | Saintpaulhealthcarept, Inc. | Home Health | 839 E Montgomery St, Henderson, NC 27536 | 2015-07-17 |
1518369859 | Kristina Thornton | Pharmacist | 200 North Cooper Road, Henderson, NC 27536 | 2014-09-18 |
1306285135 | Green Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 429 Sunnyview Road, Henderson, NC 27536 | 2013-06-14 |
1760820278 | Innovative Health Services | In Home Supportive Care | 1758 Parham Street, Henderson, NC 27536 | 2013-06-06 |
1578900015 | Frances Veronica Finamore | Counselor | 710 Parham Street, Henderson, NC 27536 | 2013-05-23 |
1952530834 | Sucessful Achievements Program Incorporated | Driver | 133 Us 1 A, Norlina, NC 27536 | 2009-07-13 |
1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
Find all providers in zip 27536 |
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 |
---|---|---|---|---|
1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
1437697430 | Ahc of Henderson LLC | Skilled Nursing Facility | 1285 East Cactus Avenue, Henderson, NV 89183-7714 | 2017-02-09 |
1508303090 | Ghc of Henderson LLC | Skilled Nursing Facility | 2855 W Horizon Ridge Pkwy, Henderson, NV 89052 | 2017-01-23 |
1699111948 | Advancing Teams Management LLC | Skilled Nursing Facility | 712 Fair Park Dr, Henderson, TX 75654-3208 | 2013-05-14 |
1356402515 | Autumn Leaves Nursing and Rehab Inc | Skilled Nursing Facility | 321 Kilgore Dr, Henderson, TX 75652-5215 | 2006-12-12 |
1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
1316034598 | Thi of Nevada At Henderson Convalescent LLC | Skilled Nursing Facility | 1180 E Lake Mead Pkwy, Henderson, NV 89015-5561 | 2006-10-07 |
1902997356 | Chester Co Healthcare, Inc. | Skilled Nursing Facility | 412 Juanita Dr, Henderson, TN 38340-1949 | 2006-09-28 |
1033220348 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 280 S Beckford Dr, Henderson, NC 27536-2564 | 2006-08-31 |
1922065655 | Nexion Health At Southwood Inc | Skilled Nursing Facility | 701 Fair Park Dr, Henderson, TX 75654-3207 | 2006-04-27 |
Find all providers in HENDERSON |
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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.