CRISP REGIONAL HOSPITAL, INC (NPI# 1164855755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164855755 |
| Entity Type | Organization |
| Organization Name | CRISP REGIONAL HOSPITAL, INC |
| Other Organization Name | CORDELE HEALTH AND REHABILITATION |
| Practice Address |
1106 N 4th St Cordele GA 31015 |
| Mailing Address |
1106 N 4th St Cordele GA 31015-3679 |
| Practice Telephone | 2292731227 |
| Practice Fax Number | 2292730930 |
| Mailing Telephone | 2292731227 |
| Mailing Fax Number | 2292730930 |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2018-09-06 |
| Authorized Official Name | LYNN RENEE BEARDEN (REVENUE INTEGRITY DIRECTOR) |
| Authorized Official Telephone | 2292763146 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 314000000X | Skilled Nursing Facility | 10401794 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00059892A | 05 |
| Other Name | Type Code |
|---|---|
| Cordele Health and Rehabilitation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376750976 | Crisp Regional Hospital, Inc | Clinic/Center | 216 Hospital Dr, Cordele, GA 31015-3275 | 2007-05-16 |
| 1396711099 | Crisp Regional Hospital, Inc | Pharmacy | 902 Blackshear Rd, Cordele, GA 31015 | 2006-02-23 |
| 1679836142 | Crisp Regional Hospital, Inc | Pharmacy | 902 N 7th St, 902 N 7th Street, Cordele, GA 31015 | 2012-06-20 |
| 1114134772 | Crisp Regional Hospital, Inc | Clinic/Center | 4110 Bedgood Ave, Arabi, GA 31712-3669 | 2007-05-16 |
| 1457329377 | Crisp Regional Hospital, Inc | Clinic/Center | 902 N 7th St, Cordele, GA 31015-3234 | 2006-03-08 |
| 1699740498 | Crisp Regional Hospital, Inc | Hospice Care, Community Based | 910 N 5th St, Cordele, GA 31015-3254 | 2006-02-23 |
| Street Address |
1106 N 4TH ST |
| City | CORDELE |
| State | GA |
| Zip Code | 31015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881680601 | Cordele Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 1106 N 4th St, Cordele, GA 31015-3679 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618164 | Jeffrey Allen Wessel Jr. | Physical Therapist | 1107b Greer Street, Cordele, GA 31015 | 2020-08-03 |
| 1316502024 | Clifton Anthony Jordan | Specialist | 1106 East Ave Suite J, Cordele, GA 31015 | 2019-05-08 |
| 1336678440 | Robert Kenneth Lancaster | Dentist | 604 E 15th Avenue, Cordele, GA 31015 | 2017-06-12 |
| 1457602435 | Marvin Tolbert Mcafee IIi | Physician Assistant | 416 East 4th Ave, Suite B, Cordele, GA 31015 | 2012-10-01 |
| 1568719169 | Kimberly Bertelson | Physical Therapy Assistant | 1107 Greer Street, Suite B, Cordele, GA 31015 | 2012-08-14 |
| 1134474174 | R W Leitner Od LLC | Optometrist | 716-c 16th Ave East, Cordele, GA 31015 | 2012-07-16 |
| 1790048023 | Holly K Davis | Nurse Practitioner | 602 E 16th Ave Ste B, Cordele, GA 31015 | 2012-06-21 |
| 1508141482 | Beatrice Hurt Mckee | Nurse Practitioner | 216 Hospital Drive., Cordele, GA 31015 | 2011-10-11 |
| 1669784393 | Elisabeth R Waldrip | Dentist | 115 E 14th Avenue, Cordele, GA 31015 | 2010-07-10 |
| 1063656403 | Priscilla George Thomas | Surgery | 416 E 4th Ave # A, Cordele, GA 31015 | 2009-04-29 |
| Find all providers in zip 31015 | ||||
| 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 |
|---|---|---|---|---|
| 1881680601 | Cordele Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 1106 N 4th St, Cordele, GA 31015-3679 | 2005-09-27 |
| 1194993634 | Blackshear Retirement Villa Als | Skilled Nursing Facility | 902 Blackshear Rd, Cordele, GA 31015-3665 | 2008-02-19 |
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| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1205486859 | Magnolia Manor of Liberty County, Inc. | Skilled Nursing Facility | 625 N Coastal Hwy # 17, Midway, GA 31320-3433 | 2019-09-16 |
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| 1043878721 | Keysville Ltc Management LLC | Skilled Nursing Facility | 1005 Ga Highway 88, Blythe, GA 30805-3911 | 2019-05-29 |
| 1689131724 | Favor Home Health Care Services, LLC | Skilled Nursing Facility | 51 Gallery Ct, Acworth, GA 30101-2709 | 2019-02-25 |
| 1104398866 | University Extended Care, Inc | Skilled Nursing Facility | 1005 Highway 88 N, Keysville, GA 30816 | 2018-12-19 |
| 1548745342 | Gacalhoun Snf LLC | Skilled Nursing Facility | 1387 Highway 41 N., Calhoun, GA 30701 | 2018-09-27 |
| Find all providers with the same taxonomy | ||||
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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.