BRIDGEPORT CENTER LLC (NPI# 1710421896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710421896 |
| Entity Type | Organization |
| Organization Name | BRIDGEPORT CENTER LLC |
| Practice Address |
41 Crestview Ter Bridgeport WV 26330-1010 |
| Mailing Address |
700 Chappell Rd Charleston WV 25304-2704 |
| Practice Telephone | 3048427101 |
| Practice Fax Number | 3048427104 |
| Mailing Telephone | 3043431950 |
| Mailing Fax Number | 3043431947 |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |
| Authorized Official Name | MR. LAWRENCE A PACK (MANAGER) |
| Authorized Official Telephone | 3043431950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
41 CRESTVIEW TER |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164421756 | Meadowview Manor Health Care Center Inc. | Skilled Nursing Facility | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2005-07-18 |
| 1003169459 | Rachel Riffee | Speech-Language Pathologist | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2012-10-23 |
| 1558614560 | Odyssey Rehabilitation | Skilled Nursing Facility | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2012-10-16 |
| 1558488916 | Jeanette Shannon-alix | Physical Therapist | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2007-03-23 |
| 1962528281 | Breena Glover | Speech-Language Pathologist | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2007-03-21 |
| 1609900877 | Karen Ann Smith | Physical Therapy Assistant | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| 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 |
|---|---|---|---|---|
| 1205171626 | Part Avenue Medical Associates, LLC | Skilled Nursing Facility | 80 Hooker Rd, Bridgeport, CT 06610-1316 | 2012-12-11 |
| 1033470786 | David Daryl Vaught | Skilled Nursing Facility | Rr 5 Box 108-c, Bridgeport, WV 26330 | 2012-05-30 |
| 1982918470 | Emericare Heritage LLC | Skilled Nursing Facility | Route 4, 17, Bridgeport, WV 26330-9804 | 2010-07-27 |
| 1376795146 | Robert Barry | Skilled Nursing Facility | 1413 Old Town Rd, Bridgeport, CT 06606-1442 | 2008-10-10 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| 1104946813 | The New Coleman Park | Skilled Nursing Facility | 62 Coleman St, Bridgeport, CT 06604-3419 | 2007-03-29 |
| 1003909623 | Bridgeport Health Care Center, Inc | Skilled Nursing Facility | 540 Bond Street, Bridgeport, CT 06610 | 2006-10-02 |
| 1891803490 | Heritage of Bridgeport, Inc | Skilled Nursing Facility | 505 O St, Bridgeport, NE 69336-4045 | 2006-08-25 |
| 1679515183 | Heartland-lansing of Bridgeport Oh LLC | Skilled Nursing Facility | 68222 Commercial Dr, Bridgeport, OH 43912-1520 | 2006-06-11 |
| 1558314955 | Northbridge Health Care Center, Inc. | Skilled Nursing Facility | 2875 Main Street, Bridgeport, CT 06606 | 2006-05-18 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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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.