CLC OF MERIDIAN, LLC (NPI# 1639169329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639169329 |
| Entity Type | Organization |
| Organization Name | CLC OF MERIDIAN, LLC |
| Other Organization Name | MERIDIAN COMMUNITY LIVING CENTER |
| Practice Address |
517 33rd St Meridian MS 39305-3944 |
| Practice Telephone | 6014833916 |
| Practice Fax Number | 6014833965 |
| Mailing Telephone | 6014833916 |
| Mailing Fax Number | 6014833965 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | MR. DOUGLAS M. WRIGHT JR. (MANAGING MEMBER) |
| Authorized Official Telephone | 6626803148 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 609 | MS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0230183 | 05 |
| Other Name | Type Code |
|---|---|
| Meridian Community Living Center | Doing Business As Name - Organization |
| Street Address |
517 33RD ST |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39305-3944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982257853 | Trend Health & Rehab of Meridian LLC | Skilled Nursing Facility | 517 33rd St, Meridian, MS 39305-3944 | 2019-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521053 | Shirley Home Care, LLC | Nurse's Aide | 4525 Poplar Springs Drive, Meridian, MS 39305 | 2020-09-08 |
| 1871017855 | Robbyn Lee | Nurse Practitioner | 4715 24th Place, Meridian, MS 39305 | 2017-08-01 |
| 1245686575 | Synergy Physical Therapy & Sports Medicine, LLC | Clinic/Center | 2447 47th Court, Suite F, Meridian, MS 39305 | 2016-05-05 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1982042198 | Kennerh Provine Collins | Pharmacist | 2917 56th Court, Meridian, MS 39305 | 2013-06-10 |
| 1306284880 | A1 In Home Therapy | Community Health Worker | 211 North Hills Street J6, A1 In Home Therapy, Meridian, MS 39305 | 2013-06-06 |
| 1497192876 | Taylor Farland | Dentist | 2300 North Hills, Meridian, MS 39305 | 2013-05-27 |
| 1376814533 | Priscilla Miller | Nurse Practitioner | 4715 42nd Place, Meridian, MS 39305 | 2012-01-19 |
| 1497083927 | Kelley C Gowdy | Nurse Practitioner | 4711 Poplar Springs Drive, Meridian, MS 39305 | 2009-11-20 |
| Find all providers in zip 39305 | ||||
| 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 |
|---|---|---|---|---|
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1568591428 | Meridian Manor | Skilled Nursing Facility | 1015 N Main, Meridian, TX 76665-4632 | 2007-03-05 |
| 1588758643 | Beverly Enterprises - Mississippi Inc | Skilled Nursing Facility | 4728 Hwy 39 North, Meridian, MS 39301 | 2006-10-03 |
| 1265470223 | Riley Healthcare LLC | Skilled Nursing Facility | 3716 Highway 39 N, Meridian, MS 39301-1013 | 2006-06-03 |
| 1265416986 | Poplar Springs Nursing Center LLC | Skilled Nursing Facility | 6615 Poplar Springs Loop, Meridian, MS 39305-9250 | 2005-12-06 |
| 1093702144 | Queen City Nursing Center Inc | Skilled Nursing Facility | 1201 28th Ave, Meridian, MS 39301-3810 | 2005-10-04 |
| 1982257853 | Trend Health & Rehab of Meridian LLC | Skilled Nursing Facility | 517 33rd St, Meridian, MS 39305-3944 | 2019-07-19 |
| 1932685583 | Meridian Healthcare, Inc. | Skilled Nursing Facility | 1351 W Pine Ave, Meridian, ID 83642-2010 | 2018-07-17 |
| 1639624620 | Diversicare of Meridian, LLC | Skilled Nursing Facility | 4728 Highway 39 N, Meridian, MS 39301-1015 | 2016-08-18 |
| Find all providers in MERIDIAN | ||||
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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.