STONERIDGE SENIOR CARE LLC (NPI# 1467436907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467436907 |
| Entity Type | Organization |
| Organization Name | STONERIDGE SENIOR CARE LLC |
| Other Organization Name | AVALON HEALTH CARE CENTER AT STONERIDGE |
| Practice Address |
186 Jerry Brown Rd Mystic CT 06355 |
| Mailing Address |
186 Jerry Brown Rd Mystic CT 06355-4004 |
| Practice Telephone | 8605725613 |
| Practice Fax Number | 8602450551 |
| Mailing Telephone | 8605369700 |
| Mailing Fax Number | 8605369300 |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2016-03-08 |
| Authorized Official Name | MARTIN E STEINBERGER (MANAGER OF MANAGING MEMBER) |
| Authorized Official Telephone | 4079992400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2305 | CT | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Avalon Health Care Center at StoneRidge | Doing Business As Name - Organization |
| Street Address |
186 JERRY BROWN RD |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| 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 |
|---|---|---|---|---|
| 1366563561 | Ssc Mystic Operating Company LLC | Skilled Nursing Facility | 44 Maritime Dr, Mystic, CT 06355-1958 | 2007-04-03 |
| 1679603732 | Mary Elizabeth Nursing Center Inc. | Skilled Nursing Facility | 28 Broadway, Mystic, CT 06355-2833 | 2007-03-07 |
| 1780635938 | Mystic Healthcare & Rehabilitation Center LLC | Skilled Nursing Facility | 475 High Street, Mystic, CT 06355 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053825091 | Athena Newtown Ct LLC | Skilled Nursing Facility | 139 Toddy Road, Newtown, CT 06470 | 2017-11-29 |
| 1255851481 | Stella Medical Care LLC | Skilled Nursing Facility | Villa At Stamford 88 Rock Rimmon Rd, Stamford, CT 06903 | 2017-06-20 |
| 1275069221 | 88 Clark Operating LLC | Skilled Nursing Facility | 88 Clark Ln, Waterford, CT 06385-2118 | 2017-05-11 |
| 1568837102 | Amanda Byrnes | Skilled Nursing Facility | 19 Sandra Ave, Terryville, CT 06786-5016 | 2015-12-08 |
| 1629447727 | Medi-np, LLC | Skilled Nursing Facility | 25 Hidden Pines Cir, Meriden, CT 06451-2212 | 2015-09-18 |
| 1982072062 | Waterbury Gardens Nursing and Rehab LLC | Skilled Nursing Facility | 128 Cedar Ave, Waterbury, CT 06705-2700 | 2015-09-08 |
| 1275918443 | 55 Kondracki Lane Operations LLC | Skilled Nursing Facility | 55 Kondracki Ln, Wallingford, CT 06492-4951 | 2015-07-29 |
| 1285012369 | Katherine Bushey | Skilled Nursing Facility | 1270 Sherman Ave, Hamden, CT 06514-1330 | 2015-05-11 |
| 1053798256 | Ltc Dental LLP | Skilled Nursing Facility | 174 Scott Rd, Prospect, CT 06712-1300 | 2015-04-27 |
| 1316354228 | Maplewood Mayflower Place Snf LLC | Skilled Nursing Facility | 1 Gorham Is, Westport, CT 06880-3217 | 2014-07-14 |
| 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.