SOUTH ROANOKE LIFE CARE, LLC (NPI# 1093799439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093799439 |
| Entity Type | Organization |
| Organization Name | SOUTH ROANOKE LIFE CARE, LLC |
| Other Organization Name | SOUTH ROANOKE NURSING HOME |
| Practice Address |
3823 Franklin Rd Sw Roanoke VA 24014 |
| Practice Telephone | 5403444325 |
| Practice Fax Number | 5403420316 |
| Mailing Telephone | 5403444325 |
| Mailing Fax Number | 5403420316 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | MR. JAMES L HAINES (CHIEF COMPLIANCE OFFICER & GENERAL) |
| Authorized Official Telephone | 5407744263 |
| Authorized Official Credential | J.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 49-5002 | VA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| South Roanoke Nursing Home | Doing Business As Name - Organization |
| Street Address |
3823 FRANKLIN RD SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558602 | Irene Pace Seidman | Pharmacist | 3350 Clearbrook Village Ln, Roanoke, VA 24014 | 2020-11-04 |
| 1720617970 | Mounica Reddy Thootkur | Student in an Organized Health Care Education/Training Program | 2017 South Jefferson Street, 2nd Floor, Roanoke, VA 24014 | 2020-04-08 |
| 1326675422 | Bharath Muppala | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2020-03-26 |
| 1235629239 | Sanjeeb Sudarshan Bhandari | Student in an Organized Health Care Education/Training Program | 1906 Bellview Ave Se, Roanoke, VA 24014 | 2018-05-15 |
| 1104325778 | Vera J. Short | Registered Nurse | 3167 Huffman Ln, Roanoke, VA 24014 | 2018-02-08 |
| 1770001380 | Michael Alan Phillips I | Social Worker | 2017 Jefferson Street, Roanoke, VA 24014 | 2017-09-03 |
| 1306362884 | Sara Alicia Guasch | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 24014 | 2017-08-16 |
| 1790212256 | Pouya Mafi | Student in an Organized Health Care Education/Training Program | 1906 Belleview Ave, Carilion Roanoke Memorial Hospital, Roanoke, VA 24014 | 2017-05-16 |
| 1790222867 | Mara Cate | Physician Assistant | 523 Arbuttus Ave, Roanoke, VA 24014 | 2017-01-26 |
| 1508314634 | Dknl Enterprises, Inc. | Non-emergency Medical Transport (VAN) | 3629 Franklin Rd Sw Suite 205b, Roanoke, VA 24014 | 2016-09-19 |
| Find all providers in zip 24014 | ||||
| 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 |
|---|---|---|---|---|
| 1346616422 | Friendship Health and Rehab Center South Inc | Skilled Nursing Facility | 5647 Starkey Rd, Roanoke, VA 24018-9034 | 2015-08-12 |
| 1558444505 | Avante At Roanoke, Inc. | Skilled Nursing Facility | 324 King George Ave Sw, Roanoke, VA 24016-5213 | 2006-10-23 |
| 1205918794 | Apostolic Christian Home of Roanoke Illinois Inc. | Skilled Nursing Facility | 1102 W Randolph St, Roanoke, IL 61561-7528 | 2006-10-20 |
| 1245330299 | Our Lady of The Valley, Inc. | Skilled Nursing Facility | 650 N Jefferson St, Roanoke, VA 24016-1427 | 2006-09-22 |
| 1235242322 | Springtree Health Care Center Ltm | Skilled Nursing Facility | 3433 Springtree Dr Ne, Roanoke, VA 24012-6443 | 2006-08-16 |
| 1679686877 | Medical Facilities of America Li | Skilled Nursing Facility | 1527 Grandin Rd Sw, Roanoke, VA 24015-2305 | 2006-08-15 |
| 1295770162 | Virginia Lutheran Homes, Inc. | Skilled Nursing Facility | 3837 Brandon Ave Sw, Roanoke, VA 24018-1441 | 2006-06-17 |
| 1477597227 | Roanoke Healthcare Center LLC | Skilled Nursing Facility | 680 Seymour Dr, Roanoke, AL 36274-1547 | 2006-06-15 |
| 1407897135 | Generation Leasing Company II, LLC | Skilled Nursing Facility | 4355 Pheasant Ridge Rd, Roanoke, VA 24014-5272 | 2006-06-10 |
| 1366493066 | Phoenix Healthcare LLC | Skilled Nursing Facility | 1235 Yancey St, Roanoke, AL 36274-2141 | 2006-05-15 |
| Find all providers in ROANOKE | ||||
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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.