PGN OP SUMMIT LLC (NPI# 1871107961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871107961 |
| Entity Type | Organization |
| Organization Name | PGN OP SUMMIT LLC |
| Practice Address |
935 N Cassady Ave Columbus OH 43219-2283 |
| Mailing Address |
525 Chestnut St Ste 102 Cedarhurst NY 11516-2223 |
| Practice Telephone | 6142524987 |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |
| Authorized Official Name | SAMUEL GOLDNER (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7326459800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Summit's Trace Healthcare Center | Doing Business As Name - Organization |
| Street Address |
935 N CASSADY AVE |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43219-2283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982694311 | Lutheran Senior City | Skilled Nursing Facility | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2005-10-26 |
| 1659992949 | Melanie Kathleen Parker | Occupational Therapist | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2020-04-28 |
| 1093357626 | Jack Alexander Van Horn | Physical Therapist | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2019-10-15 |
| 1508322546 | Peregrine Health Services of Columbus LLC | Assisted Living Facility | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2019-02-14 |
| 1417330994 | Victoria Cornell Riordan | Counselor | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2015-07-02 |
| 1316219157 | Chad Holland | Physical Therapist | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2012-02-08 |
| 1588803985 | Peregrine Health Services of Columbus LLC | Assisted Living Facility | 935 N Cassady Ave, Columbus, OH 43219-2283 | 2009-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430844 | Pdq Transportation Inc | Secured Medical Transport (VAN) | 1640 E 5th Ave, Columbus, OH 43219 | 2020-06-06 |
| 1366066599 | Urban Limousine LLC | Secured Medical Transport (VAN) | 1640 E. 5th Ave, Columbus, OH 43219 | 2020-06-03 |
| 1841757879 | Camille Cook | Nurse Practitioner | 4200 Regent St. Suite 200, Columbus, OH 43219 | 2019-02-26 |
| 1164904595 | Vida Yeboah | Registered Nurse | 2320 Doneen Dr, Columbus, OH 43219 | 2018-09-01 |
| 1407373129 | Chevon Marie Wiseman | Nurse's Aide | 2835 Jared Pl, Columbus, OH 43219 | 2017-08-23 |
| 1952826737 | Hilary Schadle Demostenes | Social Worker | 2780 Airport Dr, Suite 100 - Billing/credentialing Dept., Columbus, OH 43219 | 2017-08-14 |
| 1851833800 | Amanda Yahn | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Road, Bradford School, Columbus, OH 43219 | 2016-11-08 |
| 1215312939 | Taylor Weary | Student in an Organized Health Care Education/Training Program | 2649 Stelzer Rd, Columbus, OH 43219 | 2015-07-23 |
| 1568846715 | Brenton Semplak | Student in an Organized Health Care Education/Training Program | 2469 Stelzer Rd., Columbus, OH 43219 | 2015-07-17 |
| 1811384746 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 4142 Seward Street, Suite F105, Columbus, OH 43219 | 2015-04-17 |
| Find all providers in zip 43219 | ||||
| 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 |
|---|---|---|---|---|
| 1629694229 | The Laurels of West Columbus, LLC | Skilled Nursing Facility | 441 Norton Rd, Columbus, OH 43228 | 2020-06-19 |
| 1760927677 | Monalisa E Banda | Skilled Nursing Facility | 2410 Hannaway Ln, Columbus, OH 43229-6803 | 2016-12-31 |
| 1447673207 | Millennium Home Health Care, Inc. | Skilled Nursing Facility | 4207 Westview Center Plz, Columbus, OH 43228-2975 | 2014-01-30 |
| 1245653302 | Columbus Health Care, Inc. | Skilled Nursing Facility | 4715 38th St, Columbus, NE 68601-1622 | 2014-01-27 |
| 1225459423 | Chelsea English | Skilled Nursing Facility | 1311 18th Ave Apt A, Columbus, GA 31901-3883 | 2013-12-16 |
| 1912338567 | Perry L Foster | Skilled Nursing Facility | 1652 Old Henderson Rd, Columbus, OH 43220-3618 | 2013-12-09 |
| 1417398959 | Focus Staff | Skilled Nursing Facility | 277 Woodland Ave, Columbus, OH 43203-1747 | 2013-07-12 |
| 1790027340 | Ohio Aging Services Network | Skilled Nursing Facility | 17 S. High St., Suite 1000, Columbus, OH 43215-3481 | 2013-03-21 |
| 1639314982 | West Wharton County Hospital District | Skilled Nursing Facility | 1511 Montezuma Street, Columbus, TX 78934-2122 | 2008-12-15 |
| 1023271392 | Kindred Nursing Centers East LLC | Skilled Nursing Facility | 2770 Clime Rd, Columbus, OH 43223-3626 | 2008-07-08 |
| Find all providers in COLUMBUS | ||||
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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.