LONGLEAF NEURO-MEDICAL TREATMENT CENTER (NPI# 1942416300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942416300 |
| Entity Type | Organization |
| Organization Name | LONGLEAF NEURO-MEDICAL TREATMENT CENTER |
| Practice Address |
4761 Ward Blvd Wilson NC 27893 |
| Mailing Address |
4761 Ward Blvd Wilson NC 27893-4359 |
| Practice Telephone | 2523992112 |
| Practice Fax Number | 2523992138 |
| Mailing Telephone | 2523992112 |
| Mailing Fax Number | 2523992138 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | MR. J. LUCKEY WELSH JR. (DIRECTOR - DSOHF) |
| Authorized Official Telephone | 9198554700 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406177 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174669691 | Longleaf Neuro-medical Treatment Center | Alzheimer Center (Dementia Center) | 4761 Ward Blvd, Wilson, NC 27893 | 2007-01-30 |
| 1144370248 | Longleaf Neuro-medical Treatment Center | Skilled Nursing Facility | 4761 Ward Blvd, Wilson, NC 27893 | 2007-01-11 |
| Street Address |
4761 WARD BLVD |
| City | WILSON |
| State | NC |
| Zip Code | 27893 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669420733 | Martin Keith Williams | Psychiatry & Neurology | 4761 Ward Blvd, Nc Special Care Center, Wilson, NC 27893 | 2006-05-04 |
| 1972061851 | Ericka Deanna Packer | Physical Therapy Assistant | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2019-03-09 |
| 1700177060 | Sheryl A Beck | Pharmacy Technician | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-21 |
| 1164713426 | Ivy Jackie Sanders | Pharmacy Technician | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-21 |
| 1164713434 | Cindy Taylor Whitley | Pharmacy Technician | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-21 |
| 1932490299 | Tonya Uzzell Best | Pharmacist | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-21 |
| 1982995254 | Patricia S Price | Pharmacist | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-21 |
| 1528359940 | David Christopher Fazakerly | Pharmacy Technician | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2011-04-20 |
| 1174669691 | Longleaf Neuro-medical Treatment Center | Alzheimer Center (Dementia Center) | 4761 Ward Blvd, Wilson, NC 27893 | 2007-01-30 |
| 1710038732 | Longleaf Neuro Medical Treatment Center | Pharmacy | 4761 Ward Blvd, Wilson, NC 27893-4359 | 2007-01-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847524 | Graceland Student Services LLC | Early Intervention Provider Agency | 610 Fairview Ave., Wilson, NC 27893 | 2020-09-30 |
| 1508477894 | Evan Michael Abatiell | Specialist/Technologist | 400 Atlantic Christian E West Ne, Wilson, NC 27893 | 2020-08-11 |
| 1679100606 | Newgreen Inhomecare Group Inc | Registered Nurse | 121 Nast Street N, Wilson, NC 27893 | 2020-03-27 |
| 1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
| 1679043244 | Madison Rose Propst | Social Worker | 2416 Bedgood, Wilson, NC 27893 | 2018-11-27 |
| 1104396753 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2500 Horton Blvd, Wilson, NC 27893 | 2018-11-27 |
| 1528545498 | North Carolina In-home Partner-viii, LLC | Home Health | 1901 Tarboro St Sw Ste 304, Wilson, NC 27893 | 2018-07-24 |
| 1518478957 | Home Away From Home, Inc. | In Home Supportive Care | 1723 Meadowbrook Lane W., Wilson, NC 27893 | 2017-10-12 |
| 1942721295 | Sandra Susan Blazek | Social Worker | 608 Nash Street Nw, Wilson, NC 27893 | 2017-06-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| Find all providers in zip 27893 | ||||
| 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 |
|---|---|---|---|---|
| 1104176338 | Skill Creations of Wilson | Nursing Facility/Intermediate Care Facility | 2000 Martin Luther King Jr Pkwy Se, Wilson, NC 27893-5657 | 2012-09-14 |
| 1295810240 | Avante At Wilson, Inc. | Nursing Facility/Intermediate Care Facility | 1804 Forest Hills Rd W, Wilson, NC 27893-3413 | 2006-10-26 |
| 1902093339 | Britthaven, Inc. | Nursing Facility/Intermediate Care Facility | 403 Crestview Ave Sw, Wilson, NC 27893-4505 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841617974 | Christopher Rushmeyer | Nursing Facility/Intermediate Care Facility | 1820 Harris Houston Rd, Unit 621411, Charlotte, NC 28262-9253 | 2014-03-26 |
| 1306284674 | Legacy | Nursing Facility/Intermediate Care Facility | 903 W Main Street, Yadkinville, NC 27055 | 2013-06-10 |
| 1194077024 | Skill Creations | Nursing Facility/Intermediate Care Facility | 2101 Royall Ave, Goldsboro, NC 27534-7408 | 2012-10-02 |
| 1093066375 | Sci-east | Nursing Facility/Intermediate Care Facility | 338 Cooper St, Winterville, NC 28590-9507 | 2012-09-26 |
| 1053662437 | Skill Creations of Clinton | Nursing Facility/Intermediate Care Facility | 223 Forest Trail, Clinton, NC 28328-3353 | 2012-09-26 |
| 1821349101 | Sci-duplin House | Nursing Facility/Intermediate Care Facility | 120 Orville Street, Warsaw, NC 28398-2221 | 2012-09-26 |
| 1801147186 | Skill Creations of Kenansville | Nursing Facility/Intermediate Care Facility | 218 S Stokes Street, Kenansville, NC 28349-0001 | 2012-09-26 |
| 1750632030 | Sci-coastal House I and II | Nursing Facility/Intermediate Care Facility | 1974 W Lakeshore Drive, Wilmington, NC 28401-6856 | 2012-09-26 |
| 1760732994 | Sci-triangle House II | Nursing Facility/Intermediate Care Facility | 1523 Tyonek Dr, Durham, NC 27703-5639 | 2012-09-14 |
| 1275883498 | Skill Creations of Kinston | Nursing Facility/Intermediate Care Facility | 901 Doctors Dr, Kinston, NC 28501-1574 | 2012-09-14 |
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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.