120 MURRAY STREET OPERATIONS LLC (NPI# 1316323074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316323074 |
| Entity Type | Organization |
| Organization Name | 120 MURRAY STREET OPERATIONS LLC |
| Other Organization Name | GLEN RIDGE NURSING CARE CENTER |
| Practice Address |
120 Murray Street Medford MA 02155 |
| Practice Telephone | 7813910800 |
| Practice Fax Number | 7813910801 |
| Mailing Telephone | 7813910800 |
| Mailing Fax Number | 7813910801 |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | MICHAEL T BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684742 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUMMIT CARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 00000 | MA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | AETNA | 49447611423151 | 01 |
| Other Name | Type Code |
|---|---|
| Glen Ridge Nursing Care Center | Doing Business As Name - Organization |
| Street Address |
120 MURRAY STREET |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760479349 | Cpl (glen Ridge) LLC | Skilled Nursing Facility | 120 Murray Street, Medford, MA 02155-1300 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| 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 |
|---|---|---|---|---|
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| 1730386509 | Hearthstone | Skilled Nursing Facility | 2901 E Barnett Rd, Medford, OR 97504-8308 | 2007-06-27 |
| 1114965894 | Waterford Operations, LLC | Skilled Nursing Facility | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2006-06-03 |
| 1033164272 | Courtyard Nursing Care Center Partnership | Skilled Nursing Facility | 200 Governors Ave, Medford, MA 02155-1644 | 2006-05-24 |
| 1679563464 | Nursing Care Center At Medford Inc | Skilled Nursing Facility | 3115 Horseblock Rd, Medford, NY 11763 | 2005-10-24 |
| 1225025455 | Michael F Flanagan, Receiver for Medfors Nursing Home | Skilled Nursing Facility | 616 S Front St, Medford, OK 73759-1714 | 2005-10-03 |
| 1760479349 | Cpl (glen Ridge) LLC | Skilled Nursing Facility | 120 Murray Street, Medford, MA 02155-1300 | 2005-09-29 |
| 1639170988 | Rogue Valley Manor | Skilled Nursing Facility | 1200 Mira Mar Ave, Medford, OR 97504-8546 | 2005-08-09 |
| 1467459008 | Medford Convalescent & Nursing Center | Skilled Nursing Facility | 185 Tuckerton Rd, Medford, NJ 08055-8803 | 2005-06-28 |
| 1144223454 | Winthrop House Senior Services, LLC | Skilled Nursing Facility | 300 Winthrop St, Medford, MA 02155-2311 | 2005-05-31 |
| Find all providers in MEDFORD | ||||
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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.