COFFEE MEDICAL GROUP LLC (NPI# 1063509271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063509271 |
| Entity Type | Organization |
| Organization Name | COFFEE MEDICAL GROUP LLC |
| Other Organization Name | UNITED REGIONAL MEDICAL CENTER NURSING HOME |
| Practice Address |
1001 Mcarthur Drive Manchester TN 37355 |
| Practice Telephone | 9317283586 |
| Practice Fax Number | 9317230781 |
| Mailing Telephone | 9317283586 |
| Mailing Fax Number | 9317230781 |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | HOLLY B HOPKINS (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 9314613425 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 7440354 | TN | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 445383 | TN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 7440354 | 05 | |
| TN | BCBS | 4039933 | 01 |
| TN | 0445383 | 05 |
| Other Name | Type Code |
|---|---|
| United Regional Medical Center Nursing Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013969179 | Coffee Medical Group LLC | General Acute Care Hospital | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-05-17 |
| 1114209400 | Coffee Medical Group LLC | Internal Medicine | 1001 Mcarthur St, Manchester, TN 37355-2419 | 2011-09-13 |
| 1700192028 | Coffee Medical Group LLC | Clinic/Center | 1615 Mcminnville Hwy, Manchester, TN 37355-3179 | 2010-08-24 |
| 1043537046 | Coffee Medical Group LLC | Clinic/Center | 482 Interstate Dr, Suite A, Manchester, TN 37355-3109 | 2010-04-29 |
| 1104995281 | Coffee Medical Group LLC | General Acute Care Hospital | 1001 Mcarthur St, Manchester, TN 37355-2419 | 2006-11-06 |
| Street Address |
1001 MCARTHUR DRIVE |
| City | MANCHESTER |
| State | TN |
| Zip Code | 37355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857126 | Ashley Harmon Layne | Speech-Language Pathologist | 205 S Woodland St, Manchester, TN 37355 | 2018-07-17 |
| 1760996771 | Quad/med, LLC | Clinic/Center | 227 Monogard Rd, Manchester, TN 37355 | 2017-11-29 |
| 1881108157 | Sarabeth Seagreaves | Specialist/Technologist | 1700 Summer St Apt A36, Manchester, TN 37355 | 2017-11-25 |
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1316361561 | Charlotte Gibbs | Counselor | 482 Interstate Dr Ste D, Manchester, TN 37355 | 2014-02-08 |
| 1205258191 | Aleene Marie Falk | Social Worker | 218 Forrestwood Drive, Manchester, TN 37355 | 2014-01-10 |
| 1790067429 | Reda Lynn Lawson | Registered Nurse | 800 Parks Street, Manchester, TN 37355 | 2011-09-20 |
| 1912294117 | Patricia Beth Elliott | Nurse Practitioner | 804 Keylon Street, Manchester, TN 37355 | 2011-07-08 |
| 1427241421 | Kimberly D. Mathis | Nurse Practitioner | 1600 Mcarthur Street, Manchester, TN 37355 | 2007-08-22 |
| 1982761441 | Richard Eugene Fishbein | Orthopaedic Surgery | 102 East High Street, Manchester, TN 37355 | 2007-01-03 |
| Find all providers in zip 37355 | ||||
| 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 |
|---|---|---|---|---|
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1538467717 | Health Services Manchester, LLC | Skilled Nursing Facility | 811 Keylon Street, Manchester, TN 37355-2419 | 2011-03-11 |
| 1558594374 | Esther Hottentot | Skilled Nursing Facility | 235 Myrtle Street, Manchester, NH 03104 | 2009-08-27 |
| 1790843100 | Bidwell Care Center LLC | Skilled Nursing Facility | 333 Bidwell St, Manchester, CT 06040-6469 | 2006-12-05 |
| 1568520963 | Westside Care Center LLC | Skilled Nursing Facility | 349 Bidwell Street, Manchester, CT 06040 | 2006-12-05 |
| 1336151547 | Manchester Health Center, Inc | Skilled Nursing Facility | 565 Vernon St, Manchester, CT 06042-2409 | 2006-08-13 |
| 1053346668 | Cfn Manchester-center LLC | Skilled Nursing Facility | 198 Pearl St, Manchester, NH 03104-4357 | 2006-07-11 |
| 1114952728 | Cfn Manchester East LLC | Skilled Nursing Facility | 1276 Hanover St, Manchester, NH 03104-5623 | 2006-07-11 |
| 1659301869 | Good Neighbor Society | Skilled Nursing Facility | 105 Mccarren Drive, Manchester, IA 52057-1835 | 2006-07-04 |
| 1114964905 | Kentucky Medical Investors, LLC | Skilled Nursing Facility | 1033 N Highway 11, Manchester, KY 40962-5478 | 2006-06-01 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 37355 |
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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.