MRS. KRISTIE LYNN KOMOROWSKI (NPI# 1891034112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891034112 |
| Entity Type | Individual |
| Full Name | MRS. KRISTIE LYNN KOMOROWSKI |
| Credential | MS,CCC/SLP |
| Practice Address |
415 Benedum Dr Bridgeport WV 26330-1503 |
| Practice Telephone | 3048429887 |
| Practice Fax Number | 3048429888 |
| Mailing Telephone | 3048429887 |
| Mailing Fax Number | 3048429888 |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | SLP-0942 | WV | Nursing & Custodial Care Facilities |
| Street Address |
415 BENEDUM DR |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061249 | Rachel F. Weber | Specialist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2005-05-27 |
| 1851900708 | Erica Sengewalt | Physical Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2020-07-27 |
| 1124682406 | Gregory Lee Roberson | Physical Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2019-04-23 |
| 1720541287 | Richard Paul Mastalski | Occupational Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2019-04-11 |
| 1467915827 | Stacy Lee Seabolt | Speech-Language Pathologist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2019-04-11 |
| 1659730661 | Danielle Wesoloski | Occupational Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2016-02-18 |
| 1730548892 | Shannon Mason | Occupational Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2016-02-17 |
| 1235528340 | Sara Johnson | Speech-Language Pathologist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2015-01-13 |
| 1326454919 | Lisa Critchfield | Occupational Therapist | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2014-07-03 |
| 1144569583 | Leon Hastings | Skilled Nursing Facility | 415 Benedum Dr, Bridgeport, WV 26330-1503 | 2013-02-05 |
| Find all providers in the same location | ||||
| 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 | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336524586 | Bridgeport Health Care Center, LLC | Nursing Facility/Intermediate Care Facility | Rt 4 Box 17, Bridgeport, WV 26330-9509 | 2015-07-29 |
| 1255427415 | Bridgeport Senior Living, LLC | Nursing Facility/Intermediate Care Facility | Rr 4 Box 17, Bridgeport, WV 26330-9509 | 2006-10-05 |
| 1861597114 | Jackson County Healthcare Authority | Nursing Facility/Intermediate Care Facility | 47065 Alabama Hwy 277, Bridgeport, AL 35740 | 2006-09-13 |
| 1528022886 | Bridgeport Care Center, Inc | Nursing Facility/Intermediate Care Facility | 102 W Cates St, Bridgeport, TX 76426-2709 | 2006-04-13 |
| 1710421896 | Bridgeport Center LLC | Nursing Facility/Intermediate Care Facility | 41 Crestview Ter, Bridgeport, WV 26330-1010 | 2016-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629453766 | Rainelle Center LLC | Nursing Facility/Intermediate Care Facility | 276 Pennsylvania Ave, Rainelle, WV 25962-1177 | 2015-07-29 |
| 1558754507 | Lewisburg Center LLC | Nursing Facility/Intermediate Care Facility | 979 Rocky Hill Rd, Ronceverte, WV 24970-8028 | 2015-03-16 |
| 1467845412 | Wellsburg Center LLC | Nursing Facility/Intermediate Care Facility | 70 Valley Haven Dr, Wellsburg, WV 26070-2625 | 2015-03-16 |
| 1508254319 | Mary Bird | Nursing Facility/Intermediate Care Facility | 590 North Poplar Fork Rd, Hurricane, WV 25526-9434 | 2014-12-31 |
| 1952536377 | Springfield Center LLC | Nursing Facility/Intermediate Care Facility | 10797 Seneca Trl S, Lindside, WV 24951-7345 | 2009-05-29 |
| 1720281975 | Pleasant Valley Nursing and Rehabilitation Center, Inc. | Nursing Facility/Intermediate Care Facility | 640 Sandhill Rd, Pt Pleasant, WV 25550-2163 | 2007-06-06 |
| 1194816025 | Lakin Hospital | Nursing Facility/Intermediate Care Facility | 1 Bateman Cir, Lakin, WV 25287-9784 | 2006-09-27 |
| 1922100031 | Morgantown Healthcare Corp | Nursing Facility/Intermediate Care Facility | 30 Vandervort Dr, Morgantown, WV 26505 | 2006-09-01 |
| 1417963000 | Wvdhhr John Manchin Sr Health Care Center | Nursing Facility/Intermediate Care Facility | 401 Guffey Street, Fairmont, WV 26554 | 2006-08-01 |
| 1750338281 | Sunbridge Putnam Health Care LLC | Nursing Facility/Intermediate Care Facility | 300 Seville Rd, Hurricane, WV 25526-9206 | 2006-05-30 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on MRS. KRISTIE LYNN KOMOROWSKI.
| 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.