Active NPI
Sunbridge Retirement Care Associates LLC
- Skilled Nursing Facility
- Rome, GA
National Provider Identifier
1104876796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 10571418
- Legal business name
- SUNBRIDGE RETIREMENT CARE ASSOCIATES LLC
- Practice address
- 809 S Broad St SW
Rome, GA 30161-4654 - Phone
- (706) 235-1337
- Fax
- (706) 235-8386
- NPI assigned
- May 12, 2006
- Organization subpart
- Yes
- Parent organization
- SUNBRIDGE HEALTHCARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William A. Mathies
- Title
- President Director
- Phone
- (505) 821-3355
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 10571418 | GA | Primary |
Addresses
Primary practice location
809 S Broad St SW
Rome, GA 30161-4654
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00142766A | Medicaid | GA |
Other names 1
- Etowah Landing Care and Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Terrace Hghts Nursing H
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Skilled Nursing Facility
- Pembroke, NC
- NPI 1194779504
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1254182400000",
"number": "1104876796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-5604",
"fax_number": "505-468-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 S BROAD ST SW",
"city": "ROME",
"state": "GA",
"postal_code": "301614654",
"telephone_number": "706-235-1337",
"fax_number": "706-235-8386"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNBRIDGE RETIREMENT CARE ASSOCIATES LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
"enumeration_date": "2006-05-12",
"last_updated": "2009-09-29",
"status": "A",
"authorized_official_last_name": "MATHIES",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PRESIDENT DIRECTOR",
"authorized_official_telephone_number": "505-821-3355"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "GA",
"license": "10571418",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00142766A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Etowah Landing Care and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.