HILLCREST CONVALESCENT CENTER, INC. (NPI# 1336142470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336142470 |
| Entity Type | Organization |
| Organization Name | HILLCREST CONVALESCENT CENTER, INC. |
| Practice Address |
1417 W Pettigrew St Durham NC 27705-4820 |
| Practice Telephone | 9192867705 |
| Practice Fax Number | 9192863772 |
| Mailing Telephone | 9192867705 |
| Mailing Fax Number | 9192863772 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | MR. THOMAS TED SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 9192867705 |
| Authorized Official Credential | NHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
NH0038 | NC | Ambulatory Health Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | NH0038 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | SKILLED MEDICAID | 3405001 | 01 |
| NC | 3496052 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659901130 | Hillcrest Convalescent Center, Inc. | Clinic/Center | 4215 University Dr Ste B2, Durham, NC 27707-2550 | 2020-01-23 |
| Street Address |
1417 W PETTIGREW ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-4820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962703769 | Sp Internal Medicine P.C. | Internal Medicine | 1417 W Pettigrew St, Durham, NC 27705-4820 | 2010-11-10 |
| 1710048582 | Hillcrest Convalescent Center Inc | Pharmacy | 1417 W Pettigrew St, Durham, NC 27705-4820 | 2006-12-13 |
| 1760460349 | Suman Prasad | Internal Medicine | 1417 W Pettigrew St, Durham, NC 27705-4820 | 2006-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| 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 |
|---|---|---|---|---|
| 1669821336 | Carver Healthcare LLC | Skilled Nursing Facility | 303 E Carver St, Durham, NC 27704-2135 | 2016-06-03 |
| 1427447549 | Geanda Tilley | Skilled Nursing Facility | 4801 Danube Ln, Apartment #823, Durham, NC 27704-1845 | 2015-01-13 |
| 1447435722 | Pruitthealth - Durham, LLC | Skilled Nursing Facility | 3100 Erwin Road, Durham, NC 27705-4505 | 2008-01-04 |
| 1619157534 | Durham Healthcare LLC | Skilled Nursing Facility | 411 S Lasalle St, Durham, NC 27705-3701 | 2007-11-08 |
| 1851437743 | Twin Maples Health Care Facility | Skilled Nursing Facility | 809 New Haven Rd # R, Durham, CT 06422-2412 | 2007-01-29 |
| 1841390010 | Treyburn Healthcare, Inc | Skilled Nursing Facility | 2059 Torredge Rd, Durham, NC 27712-1767 | 2006-09-25 |
| 1851336754 | Durham Limited Partnership IIi | Skilled Nursing Facility | 303 E. Carver Street, Durham, NC 27704-2135 | 2006-06-17 |
| 1972587376 | The United Methodist Retirement Homes, Incorporated | Skilled Nursing Facility | 2600 Croasdaile Farm Pkwy, Durham, NC 27705-1331 | 2005-11-30 |
| 1407371149 | Eagle Acquisition Iv LLC | Skilled Nursing Facility | 4230 N Roxboro St, Durham, NC 27704-1826 | 2017-08-03 |
| 1386187813 | Treyburn Rehabilitation Center, LLC | Skilled Nursing Facility | 2059 Torredge Rd, Durham, NC 27712-1767 | 2016-12-01 |
| Find all providers in DURHAM | ||||
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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.