SEAPORT VILLAGE SKILLED NURSING CENTER LLC (NPI# 1558351841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558351841 |
| Entity Type | Organization |
| Organization Name | SEAPORT VILLAGE SKILLED NURSING CENTER LLC |
| Practice Address |
19 General Moore Way Ellsworth ME 04605-1806 |
| Practice Telephone | 2076679336 |
| Mailing Telephone | 2076679336 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2014-11-19 |
| Authorized Official Name | KENNETH BOWDEN (CEO) |
| Authorized Official Telephone | 2078742700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | 36346 | ME | Speech, Language and Hearing Service Providers |
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
36346 | ME | Ambulatory Health Care Facilities |
| N | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
36346 | ME | Ambulatory Health Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 36555 | ME | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 104690000 | 05 |
| Street Address |
19 GENERAL MOORE WAY |
| City | ELLSWORTH |
| State | ME |
| Zip Code | 04605-1806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474584 | Jacklyn L Holmes | Occupational Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2020-10-13 |
| 1972114312 | Katelyn Patricia Ryan | Physical Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2020-08-10 |
| 1154948354 | Hillary Louise Pelkey | Physical Therapy Assistant | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2020-07-03 |
| 1740811983 | Kelsea Paige Bouchard | Speech-Language Pathologist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2020-01-27 |
| 1942783188 | Lindsey Rae Fisher | Occupational Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2018-09-13 |
| 1740707512 | Monica Hurst | Physical Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2017-08-23 |
| 1689029423 | Blake Stevens | Speech-Language Pathologist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2016-04-29 |
| 1629423447 | Katherine Durgin | Occupational Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2016-04-29 |
| 1053766881 | Brittany Alley | Occupational Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2016-04-29 |
| 1316391428 | Rebecca Marie Labrie | Occupational Therapist | 19 General Moore Way, Ellsworth, ME 04605-1860 | 2016-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940464 | Mary Elizabeth Wagstaff | Occupational Therapist | Seaport Village Healthcare, 19 General Moore Way, Ellsworth, ME 04605 | 2019-03-12 |
| 1154784668 | Black Dog Medical Pa | Internal Medicine | 11 Madison Avenue, Lamoine, ME 04605 | 2016-04-01 |
| 1528466687 | Eyecare Now | Point of Service | 248 State St., Ste. 7, Ellsworth, ME 04605 | 2014-12-05 |
| 1104245364 | Elizabeth Arntzen | Massage Therapist | 61 Pine St., Ellsworth, ME 04605 | 2014-04-15 |
| 1992144794 | Kenneth L Senter | Family Medicine | 248 State St., Ellsworth Free Medical Clinic, Ellsworth, ME 04605 | 2013-06-14 |
| 1639465248 | Lynne Marie Betz | Dental Hygienist | 52 Christian Ridge Road, Ellsworth, ME 04605 | 2011-06-22 |
| 1215238431 | Kimberly Ann Burgess | Social Worker | 23 Carriage Way, Ellsworth, ME 04605 | 2010-11-04 |
| 1962713115 | Springy Pond Farm | Voluntary or Charitable | 562 Springy Pond Rd., Otis, ME 04605 | 2010-06-23 |
| 1851629851 | Astor Charlene Gillis | Counselor | 59 Franklin St., Suite B, Ellsworth, ME 04605 | 2009-12-02 |
| 1326372723 | Patricia Brown Orchard | Community Health Worker | 10 Water Street, Suite 124, Ellsworth, ME 04605 | 2009-10-01 |
| Find all providers in zip 04605 | ||||
| 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 |
|---|---|---|---|---|
| 1396805511 | North Country Associates, Inc | Skilled Nursing Facility | 42 Bucksport Rd, Ellsworth, ME 04605-2230 | 2006-12-11 |
| 1205828738 | Ellsworth Care Center LLC | Skilled Nursing Facility | 403 N Maple St, Ellsworth, WI 54011-9037 | 2005-08-19 |
| 1306840368 | Parkview Manor Nursing Home | Skilled Nursing Facility | 308 W Sherman Ave, Ellsworth, MN 56129-1016 | 2005-06-08 |
| 1063055986 | Nsh Ellsworth LLC | Skilled Nursing Facility | 403 N Maple St, Ellsworth, WI 54011-9037 | 2019-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558841353 | Mainehealth | Skilled Nursing Facility | 35 July St, Sanford, ME 04073-1909 | 2018-08-21 |
| 1174906499 | Kimberly Shields | Skilled Nursing Facility | 32 Bower St, Bangor, ME 04401-4722 | 2015-07-06 |
| 1952641375 | Vk Norway, LLC | Skilled Nursing Facility | 24 Marion Ave, Norway, ME 04268-5602 | 2013-02-21 |
| 1538498464 | Carla Jane Stevens | Skilled Nursing Facility | 7 Highwood Street, Waterville, ME 04901 | 2009-12-24 |
| 1881866580 | Kittery Commons LLC | Skilled Nursing Facility | 9 Lewis Road, Kittery, ME 03904 | 2008-04-02 |
| 1790820223 | Western Maine Nursing Home Inc | Skilled Nursing Facility | 3 Market Sq, South Paris, ME 04281-1114 | 2007-02-21 |
| 1811040348 | Winthrop Manor Long Term Care & Rehab Center, Inc. | Skilled Nursing Facility | 96 Route 133, Winthrop, ME 04364-1354 | 2007-01-19 |
| 1760544100 | Waterville Snf Operations, LLC | Skilled Nursing Facility | 27 Cool St, Waterville, ME 04901-5221 | 2006-12-14 |
| 1700948122 | Lewiston Operations, LLC | Skilled Nursing Facility | 33 Roger St, Lewiston, ME 04240-3328 | 2006-12-14 |
| 1588726855 | Westbrook Operations, LLC | Skilled Nursing Facility | 300 Spring St, Westbrook, ME 04092-3915 | 2006-12-14 |
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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.