EAGLE PEAK LTC GROUP, LLC


Address: 1245 Park Ave, Henderson, NC 27536-4025
Phone: 2524927021

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility NH0353 NC Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NC BC/BS OF NC 0088D 01
NC 7806629 05
NC 3425321 05
NC 3415321 05

Other Provider/Organization Names

Other Name Type Code
Kerr Lake Nursing and Rehabilitation Center Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1245 PARK AVE
City HENDERSON
State NC
Zip Code 27536-4025

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(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.

Providers in the same taxonomy and city

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
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City HENDERSON
Zip Code 27536

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Dataset Information

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.

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