ARCHDALE NURSING CENTER, INC. (NPI# 1588642102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588642102 |
| Entity Type | Organization |
| Organization Name | ARCHDALE NURSING CENTER, INC. |
| Other Organization Name | THE GRAYBRIER NURSING & RETIREMENT CENTER |
| Practice Address |
116 Lane Dr Trinity NC 27370-9343 |
| Practice Telephone | 3364318888 |
| Practice Fax Number | 3364319053 |
| Mailing Telephone | 3364318888 |
| Mailing Fax Number | 3364319053 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SARAH BENNETT (CONTROLLER/ASSIST. ADMINISTRATOR) |
| Authorized Official Telephone | 3364318888 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 314000000X | Skilled Nursing Facility | NH0489 | NC | Nursing & Custodial Care Facilities |
| X | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
NH0489 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7801536 | 05 | |
| NC | 3405330 | 05 |
| Other Name | Type Code |
|---|---|
| The GrayBrier Nursing & Retirement Center | Doing Business As Name - Organization |
| Street Address |
116 LANE DR |
| City | TRINITY |
| State | NC |
| Zip Code | 27370-9343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568802437 | John Broome II | Occupational Therapy Assistant | 116 Lane Dr, Trinity, NC 27370-9343 | 2013-06-25 |
| 1053759647 | Arnold Gallo | Physical Therapist | 116 Lane Dr, Trinity, NC 27370-9343 | 2013-06-05 |
| 1225372774 | Paul Ainsworth Effinger | Occupational Therapy Assistant | 116 Lane Dr, Trinity, NC 27370-9343 | 2012-11-23 |
| 1568706000 | Corrine Louise Mfune | Occupational Therapy Assistant | 116 Lane Dr, Trinity, NC 27370-9343 | 2012-11-22 |
| 1871837351 | Audra Butler | Speech-Language Pathologist | 116 Lane Dr, Trinity, NC 27370-9343 | 2012-11-21 |
| 1548504285 | John Montgomery Shields II | Physical Therapy Assistant | 116 Lane Dr, Trinity, NC 27370-9343 | 2012-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316106784 | Owena A. Blair | Speech-Language Pathologist | 956 Harris Rd, Trinity, NC 27370-7059 | 2008-06-02 |
| 1659723674 | Tosha Medlin Briles | Nurse Practitioner | 3942 Shadydale Acres Ln, Trinity, NC 27370-7741 | 2016-07-01 |
| 1720351646 | Lisa R Miller | Nutritionist | 7495 Fox Chase Dr, Trinity, NC 27370-7778 | 2012-02-23 |
| 1235522251 | Reshma Dilipkumar Patel | Home Health | 6406 Derby Way, Trinity, NC 27370-7781 | 2015-03-16 |
| 1841826096 | Ashton Allen | Speech-Language Pathologist | 4728 Jordan Valley Rd, Trinity, NC 27370-8858 | 2020-03-19 |
| 1013475094 | Denise Cadle Rhew | Registered Nurse | 6412 Longview Ave, Trinity, NC 27370-8871 | 2019-03-07 |
| 1871837856 | Angela Deona Dinkins | Home Health Aide | 4451 Regina St, Trinity, NC 27370-8912 | 2012-11-15 |
| 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. |
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|---|---|---|---|---|
| 1710435383 | Trinity Rhc LLC | Skilled Nursing Facility | 314 E Caroline St, Trinity, TX 75862-7205 | 2016-09-13 |
| 1578833463 | Staffus Healthcare | Skilled Nursing Facility | 2336 Seven Springs Blvd, Trinity, FL 34655-3909 | 2012-01-09 |
| 1144404716 | Eastlake Rehab & Care Center LLC | Skilled Nursing Facility | 2144 Welbilt Blvd, Trinity, FL 34655-5186 | 2007-12-19 |
| 1619955416 | Heartway IIi Corporation | Skilled Nursing Facility | 808 S Robb St, Trinity, TX 75862-7602 | 2006-01-03 |
| 1427347582 | Apn, LLC | Skilled Nursing Facility | 2144 Welbilt Blvd, Trinity, FL 34655-5186 | 2011-03-29 |
| 1336190347 | Liberty County Hospital District No. 1 | Skilled Nursing Facility | 808 S Robb St, Trinity, TX 75862-7602 | 2006-05-15 |
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|---|---|---|---|---|
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| 1871063214 | Vero Health X, LLC | Skilled Nursing Facility | 417 Cloverdale Rd, Sylva, NC 28779-0679 | 2018-11-28 |
| 1821573809 | Carolina Bay Healthcare Center of Wilmington, LLC | Skilled Nursing Facility | 740 Diamond Shoals Rd, Wilmington, NC 28403-4388 | 2018-09-26 |
| 1093228397 | Bellarose Nursing and Rehab Center, Inc. | Skilled Nursing Facility | 200 Bellarose Lake Way, Garner, NC 27529-7049 | 2017-11-08 |
| 1558872333 | Brunswick Health & Rehab Center, LLC | Skilled Nursing Facility | 9600 No 5 School Rd Nw, Ash, NC 28420-2122 | 2017-10-19 |
| 1538684212 | Eagle Acquisition Vi LLC | Skilled Nursing Facility | 901 S Halstead Blvd., Elizabeth City, NC 27909-6920 | 2017-08-03 |
| 1982130811 | Ashton Health and Rehabilitation, LLC | Skilled Nursing Facility | 5533 Burlington Rd, Mc Leansville, NC 27301-9622 | 2017-05-11 |
| 1831625037 | Supplemental Healthcare | Skilled Nursing Facility | 319 Vancouver Drive, Apartment 38g, Fayetteville, NC 28303 | 2017-05-08 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
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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.