TAR RIVER LTC GROUP, LLC (NPI# 1992741391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992741391 |
| Entity Type | Organization |
| Organization Name | TAR RIVER LTC GROUP, LLC |
| Other Organization Name | ROANOKE RIVER NURSING AND REHABILITATION CENTER |
| Practice Address |
119 Gatlin St Williamston NC 27892-2560 |
| Practice Telephone | 2527921616 |
| Practice Fax Number | 2527921908 |
| Mailing Telephone | 2527921616 |
| Mailing Fax Number | 2527921908 |
| Enumeration Date | 2006-06-22 |
| 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 | NH0270 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3465145 | 05 | |
| NC | BC/BS OF NC | 0093A | 01 |
| NC | 3455145 | 05 |
| Other Name | Type Code |
|---|---|
| Roanoke River Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285660787 | Tar River Ltc Group, LLC | Respite Care | 1084 Us Highway 64 E, Plymouth, NC 27962-9215 | 2006-06-25 |
| 1750317897 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 250 Lovers Ln, Washington, NC 27889-3436 | 2006-06-23 |
| 1770529141 | Tar River Ltc Group, LLC | Custodial Care Facility | 3210 Western Blvd, Tarboro, NC 27886-1828 | 2006-06-22 |
| 1356386445 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 430 W Health Center Dr, Nags Head, NC 27959-8943 | 2006-06-20 |
| 1083659692 | Tar River Ltc Group, LLC | Clinic/Center | 1341 Paradise Rd, Edenton, NC 27932-8503 | 2006-06-18 |
| 1013951896 | Tar River Ltc Group, LLC | Skilled Nursing Facility | 200 Hampton Woods Complex, Jackson, NC 27845-9503 | 2006-06-15 |
| 1184809279 | Tar River Ltc Group, LLC | Nursing Facility/Intermediate Care Facility | 1084 Us Highway 64 E, Plymouth, NC 27962-9215 | 2008-01-08 |
| Street Address |
119 GATLIN ST |
| City | WILLIAMSTON |
| State | NC |
| Zip Code | 27892-2560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013386523 | Jamielou Sevilla | Occupational Therapist | 119 Gatlin St, Williamston, NC 27892-2560 | 2015-09-15 |
| 1841442183 | Angela Roberson Keel | Community Health Worker | 119 Gatlin St, Williamston, NC 27892-2560 | 2008-10-17 |
| 1184811515 | Britthaven, Inc. | Nursing Facility/Intermediate Care Facility | 119 Gatlin St, Williamston, NC 27892-2560 | 2007-10-01 |
| 1861683302 | Wanda J Hopkins | Physical Therapy Assistant | 119 Gatlin St, Williamston, NC 27892-2560 | 2007-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841844388 | A Ray of Hope Enterprise LLC | Counselor | 115 E. Main St, Williamston, NC 27892 | 2019-08-01 |
| 1689145476 | Michael Thomas Parrella | Physician Assistant | 2150, 310 South Mccaskey Road, Williamston, NC 27892 | 2018-12-06 |
| 1285136762 | Myeyedr Optometry of North Carolina, Pllc | Optometrist | 1227 Brentway Ave, Williamston, NC 27892 | 2018-03-01 |
| 1528443843 | Jeanette Ruffin | Counselor | 223 Faith Works Community Svcs, Inc, Williamston, NC 27892 | 2015-07-28 |
| 1578719712 | Martin County Residential Services | Community/Behavioral Health | 6003 W. Main Street, Williamston, NC 27892 | 2008-08-07 |
| 1962662577 | Otis Benjamin Burnett Iv | Anesthesiology | 310 South Mckaskey Rd, Williamston, NC 27892 | 2008-06-17 |
| 1659543932 | Divine Intervention for Youth Inc. | Community/Behavioral Health | 203 Green Street, Williamston, NC 27892 | 2008-03-27 |
| 1568645521 | Earle Eugene Barnard | Physical Therapist | 115 West Boulevard, Williamston, NC 27892 | 2007-12-13 |
| 1124168141 | Martin County Residential Services Inc. | Case Manager/Care Coordinator | 6003 West Main Street, Williamston, NC 27892 | 2007-02-07 |
| 1962551374 | David T Marshburn | Dentist | 1025 Harrisway Drive, Williamston, NC 27892 | 2007-01-09 |
| Find all providers in zip 27892 | ||||
| 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 |
|---|---|---|---|---|
| 1891165767 | Casey Keel | Skilled Nursing Facility | 2060 Jack Roberson Rd, Williamston, NC 27892-8602 | 2015-10-04 |
| 1669083291 | Williamston Nursing Facility Operations Company, LLC | Skilled Nursing Facility | 119 Gatling St, Williamston, NC 27892-2560 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063756 | Cary Senior Housing I Opco, LLC | Skilled Nursing Facility | 221 Brightmore Dr, Cary, NC 27518-8145 | 2019-10-04 |
| 1629535455 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 621 Chestnut Ridge Pkwy, Blowing Rock, NC 28605-8962 | 2019-02-28 |
| 1871063214 | Vero Health X, LLC | Skilled Nursing Facility | 417 Cloverdale Rd, Sylva, NC 28779-0679 | 2018-11-28 |
| 1821573809 | Carolina Bay Healthcare Center of Wilmington, LLC | Skilled Nursing Facility | 740 Diamond Shoals Rd, Wilmington, NC 28403-4388 | 2018-09-26 |
| 1093228397 | Bellarose Nursing and Rehab Center, Inc. | Skilled Nursing Facility | 200 Bellarose Lake Way, Garner, NC 27529-7049 | 2017-11-08 |
| 1558872333 | Brunswick Health & Rehab Center, LLC | Skilled Nursing Facility | 9600 No 5 School Rd Nw, Ash, NC 28420-2122 | 2017-10-19 |
| 1538684212 | Eagle Acquisition Vi LLC | Skilled Nursing Facility | 901 S Halstead Blvd., Elizabeth City, NC 27909-6920 | 2017-08-03 |
| 1982130811 | Ashton Health and Rehabilitation, LLC | Skilled Nursing Facility | 5533 Burlington Rd, Mc Leansville, NC 27301-9622 | 2017-05-11 |
| 1831625037 | Supplemental Healthcare | Skilled Nursing Facility | 319 Vancouver Drive, Apartment 38g, Fayetteville, NC 28303 | 2017-05-08 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSTON |
| Zip Code | 27892 |
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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.