MT. KENN NURSING, LLC (NPI# 1053366336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053366336 |
| Entity Type | Organization |
| Organization Name | MT. KENN NURSING, LLC |
| Other Organization Name | AUTUMN BREEZE HEALTHCARE CENTER |
| Practice Address |
1480 Sandtown Road Marietta GA 30008-3821 |
| Mailing Address |
5057 Troy Road Springfield OH 45502-8150 |
| Practice Telephone | 7704421755 |
| Practice Fax Number | 7704428784 |
| Mailing Telephone | 9379648974 |
| Mailing Fax Number | 9379648961 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-07-25 |
| Authorized Official Name | BOYD P GENTRY JR. (PRESIDNET AND CEO) |
| Authorized Official Telephone | 9379648974 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | 05-47025 | GA | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 1-033-1982 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00140159A | 05 |
| Other Name | Type Code |
|---|---|
| Autumn Breeze Healthcare Center | Doing Business As Name - Organization |
| Street Address |
1480 SANDTOWN ROAD |
| City | MARIETTA |
| State | GA |
| Zip Code | 30008-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952740276 | Beta Discount Pharmacy & Health Services, LLC | Pharmacy | 776 Sandtown Rd Sw, Marietta, GA 30008 | 2013-06-19 |
| 1982935607 | Family Home Care, LLC | Respite Care | 1791 Silver Leaf Ct, Marietta, GA 30008 | 2010-01-20 |
| 1952546533 | Daniel Park | Plastic Surgery | 2285 Asquith Ave Sw Ste 200, Marietta, GA 30008 | 2008-12-10 |
| 1265657399 | Scott D Warner | Chiropractor | 3201 Austell Rd Sw, Marietta, GA 30008 | 2007-04-16 |
| 1972572642 | Cobb County Board of Health | Public Health or Welfare | 1650 County Services Parkway, Marietta, GA 30008 | 2006-03-15 |
| 1538662622 | Lorna Brown | Nurse Practitioner | 1825 County Services Pkwy Sw, Marietta, GA 30008 | 2018-03-14 |
| 1760825905 | Avantika Varma | Family Medicine | 1650 County Services Pkwy Sw Ste 200, Marietta, GA 30008 | 2013-04-08 |
| 1689887663 | Brenda W Wilson | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043423023 | Karen J Carter | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043587330 | Francine Edwards | Speech-Language Pathologist | 3665 Austell Road Sw, Suite 1017, Marietta, GA 30008-0000 | 2011-11-30 |
| Find all providers in zip 30008 | ||||
| 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 |
|---|---|---|---|---|
| 1053797340 | C.r. of Autumn Breeze, LLC | Skilled Nursing Facility | 1480 Sandtown Rd Sw, Marietta, GA 30008-3821 | 2015-08-10 |
| 1629312079 | Sundance | Skilled Nursing Facility | 145 Cox Farm Rd Nw, Marietta, GA 30064-5059 | 2012-11-23 |
| 1639241284 | Marietta Care, LLC | Skilled Nursing Facility | 400 N 7th St, Marietta, OH 45750-2024 | 2006-11-15 |
| 1184730913 | Marietta Healthcare, LLC | Skilled Nursing Facility | 117 Bartlett St, Marietta, OH 45750-2683 | 2006-08-22 |
| 1295768497 | Hcc Healthcare of Marietta, LLC | Skilled Nursing Facility | 811 Kennesaw Avenue, Marietta, GA 30060 | 2006-07-09 |
| 1164466942 | Heartland of Marietta Oh, LLC | Skilled Nursing Facility | 2501 State Route 60, Marietta, OH 45750-1271 | 2006-06-15 |
| 1619914520 | Manor Care of Marietta Ga LLC | Skilled Nursing Facility | 4360 Johnson Ferry Pl, Marietta, GA 30068-2016 | 2006-05-31 |
| 1700838265 | Ggnsc Marietta LLC | Skilled Nursing Facility | 613 Roselane St Nw, Marietta, GA 30060-6940 | 2006-05-16 |
| 1447219696 | Mpi Management, Inc | Skilled Nursing Facility | 2906 Geer Hwy, Marietta, SC 29661-9517 | 2006-03-17 |
| 1558357368 | Marietta Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 50 Saine Dr Sw, Marietta, GA 30008-3824 | 2005-09-27 |
| Find all providers in MARIETTA | ||||
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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.