HERITAGE OF BRIDGEPORT, INC (NPI# 1891803490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891803490 |
| Entity Type | Organization |
| Organization Name | HERITAGE OF BRIDGEPORT, INC |
| Other Organization Name | HERITAGE OF BRIDGEPORT |
| Practice Address |
505 O St Bridgeport NE 69336-4045 |
| Mailing Address |
505 O Street Bridgeport NE 69336-4045 |
| Practice Telephone | 3082620725 |
| Practice Fax Number | 3082620470 |
| Mailing Telephone | 3082620725 |
| Mailing Fax Number | 3082620470 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2011-06-08 |
| Authorized Official Name | MR. JACK DEAN VETTER (PRESIDENT) |
| Authorized Official Telephone | 4028953932 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 544002 | NE | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage of Bridgeport | Doing Business As Name - Organization |
| Street Address |
505 O ST |
| City | BRIDGEPORT |
| State | NE |
| Zip Code | 69336-4045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194217497 | Senex Foundation of Nebraska, Inc | Skilled Nursing Facility | 505 O St, Bridgeport, NE 69336-4045 | 2018-06-01 |
| 1619314325 | Senex Foundation of Nebraska, Inc | Skilled Nursing Facility | 505 O St, Bridgeport, NE 69336-4045 | 2013-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477608610 | Alliance Vision Source, P.C. | Optometrist | 921 Main Street, Bridgeport, NE 69336 | 2007-01-25 |
| 1497816680 | J & J Nein LLC | Pharmacy | 1012 Main St, Bridgeport, NE 69336 | 2006-12-12 |
| 1790977148 | Shawn Michael Berry | Physical Therapy Assistant | 505 Q St, Heritage of Bridgeport, Bridgeport, NE 69336-0081 | 2007-08-09 |
| 1093088155 | Amy Dawn Craig | Licensed Practical Nurse | 1014 N St, Bridgeport, NE 69336-0101 | 2012-02-20 |
| 1154433068 | James David Nein | Pharmacist | 1013 Main St, Bridgeport, NE 69336-0141 | 2006-08-31 |
| 1639449333 | Carrie C Martinson | Specialist | 1313 S St, Bridgeport, NE 69336-0579 | 2012-01-11 |
| 1356420806 | Christensen Chiropractic Clinic, P.C. | Clinic/Center | 805 Main Street, Bridgeport, NE 69336-0759 | 2006-11-03 |
| 1184835183 | Sam F. Jacoby | Dentist | 1006 Main Street, Bridgeport, NE 69336-0864 | 2007-05-24 |
| 1003260126 | Lisa Lussetto | Speech-Language Pathologist | 800 Q St, Bridgeport, NE 69336-2519 | 2016-04-14 |
| 1114572377 | Brittany Beth Norman | Registered Nurse | 800 Q St, Bridgeport, NE 69336-2519 | 2019-08-05 |
| Find all providers in zip 69336 | ||||
| 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 |
| 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 |
| 1972594182 | Parcc Healthcare Inc | Skilled Nursing Facility | 725 Park Avenue, Bridgeport, CT 06604 | 2005-11-04 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 69336 |
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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.