SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC (NPI# 1376590976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376590976 |
| Entity Type | Organization |
| Organization Name | SUNBRIDGE CLIPPER HOME OF WOLFEBORO LLC |
| Other Organization Name | WOLFEBORO BAY CENTER |
| Practice Address |
39 Clipper Dr Wolfeboro NH 03894-4222 |
| Mailing Address |
101 Sun Ave Ne Compliance Department Albuquerque NM 87109-4373 |
| Practice Telephone | 6035693950 |
| Practice Fax Number | 6035696709 |
| Mailing Telephone | 5054685604 |
| Mailing Fax Number | 5054684681 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MICHAEL BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684742 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUNBRIDGE HEALTHCARE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 02451 | NH | Nursing & Custodial Care Facilities |
| N | 311500000X | Alzheimer Center (Dementia Center) | 02451 | NH | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 02451 | NH | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 02451 | NH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GIC INDEMNITY | 850370802 | 01 | |
| NH | 99750169 | 05 | |
| ANTHEM BLUE CROSS | 0000005BC | 01 | |
| AL | BC/BS | 850370802 | 01 |
| MN | MN BC/BS | 4J47SU | 01 |
| UNICARE INDEMNITY | 850370802 | 01 |
| Other Name | Type Code |
|---|---|
| Wolfeboro Bay Center | Doing Business As Name - Organization |
| Street Address |
39 CLIPPER DR |
| City | WOLFEBORO |
| State | NH |
| Zip Code | 03894-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407321763 | Elizabeth Valcourt | Physical Therapy Assistant | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2018-10-12 |
| 1942747357 | Melissa George | Speech-Language Pathologist | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2017-01-23 |
| 1861942773 | Keelin Dougherty | Occupational Therapist | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2016-10-04 |
| 1477907004 | Kathleen H. Ahearn | Occupational Therapy Assistant | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2016-04-20 |
| 1588052237 | Samantha Blaisdell | Nurse Practitioner | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2015-01-05 |
| 1568867281 | Susan Ann Morrison | Physical Therapy Assistant | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2014-10-23 |
| 1871916197 | Rennae Walsh | Occupational Therapy Assistant | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2014-01-22 |
| 1720420144 | Steven Mathew Caverno | Physical Therapy Assistant | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2013-07-26 |
| 1255676474 | Courtney Bryden Guertin | Occupational Therapist | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2012-11-28 |
| 1134463458 | Amanda Whiting | Occupational Therapist | 39 Clipper Dr, Wolfeboro, NH 03894-4222 | 2012-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063803047 | Ccm Chiropractic Pllc | Chiropractor | 29 Mill Street Unit C4, Wolfeboro, NH 03894 | 2015-02-11 |
| 1821303777 | Charles Ellingwood Simpson | Dentist | 12 Varney Rd, Wolfeboro, NH 03894 | 2010-08-16 |
| 1932428489 | Nancy Marineau | Pharmacist | 50 South Main St, Wolfeboro, NH 03894 | 2010-05-24 |
| 1205154556 | Sarah Connelly | Pharmacist | 50 South Main St., Wolfeboro, NH 03894 | 2010-05-12 |
| 1841408457 | Richard J. Neal Jr., D.m.d. P.C. | Dentist | 190 South Main Street, Wolfeboro, NH 03894 | 2007-05-18 |
| 1114134426 | Silva Family Dentistry | Dentist | 16 Lehner Street, Wolfeboro, NH 03894 | 2007-05-17 |
| 1659593846 | Beth Marcoux | Physical Therapist | 104 Old Keewaydin Point Rd, Suite Box 1714, Wolfeboro, NH 03894 | 2007-05-03 |
| 1174644215 | Kristi Gowell Roark | Social Worker | 10 Endicot Street, Wolfeboro, NH 03894 | 2007-04-03 |
| 1285752758 | Kathleen D. Dotter | Social Worker | 84 Baystreet, Wolfeboro, NH 03894 | 2007-03-26 |
| 1922138452 | David Marsh Mccarthy | Chiropractor | 29 Mill Street, Suite C4 C5, Wolfeboro, NH 03894 | 2007-03-06 |
| Find all providers in zip 03894 | ||||
| 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 |
|---|---|---|---|---|
| 1447387527 | Huggins Hospital | Skilled Nursing Facility | 240 S Main St, Wolfeboro, NH 03894-0912 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1538403092 | Christopher Braid | Skilled Nursing Facility | 17 Old Coach Rd, Kingston, NH 03848-3441 | 2012-11-21 |
| 1558594374 | Esther Hottentot | Skilled Nursing Facility | 235 Myrtle Street, Manchester, NH 03104 | 2009-08-27 |
| 1154573921 | Christine Farnum | Skilled Nursing Facility | 18 Brenner Dr, Newton, NH 03858-3801 | 2008-10-10 |
| 1689821399 | Janet Pelletier | Skilled Nursing Facility | 46 Rangers Dr, Hudson, NH 03051-3534 | 2008-08-25 |
| 1588835904 | Innovative Placement Inc | Skilled Nursing Facility | 144 Chestnut St, Claremont, NH 03743-5845 | 2008-03-13 |
| 1467575183 | Genesis Rehabilitation Services | Skilled Nursing Facility | 4 Peabody St, Tilton, NH 03276-5407 | 2007-04-09 |
| 1447312046 | Edgewood Manor Inc | Skilled Nursing Facility | 928 South St, Portsmouth, NH 03801-5421 | 2006-12-14 |
| 1306934963 | School Street Associates | Skilled Nursing Facility | 67 School Street, Hillsboro, NH 03244 | 2006-10-10 |
| 1396832580 | Thi of New Hampshire At Derry, LLC | Skilled Nursing Facility | 8 Peabody Rd, Derry, NH 03038-1807 | 2006-10-07 |
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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.