Management Care Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000340 Issued in TN

Legal business name

MANAGEMENT CARE CORPORATION

Doing business as

Lakebridge Health Care Center

Practice address

115 Woodlawn Dr
Johnson City, TN 37604-5978

Phone

(423) 975-0095

Fax

(423) 928-0358

NPI assigned

Dec 15, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jimmy R LewisNPI 1730831363

Title

President

Phone

(423) 975-5455

Specialties & licenses 1

Addresses

Other names 1

• Lakebridge Health Care Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jimmy R Lewis

  • Skilled Nursing Facility
  • Medina, TN
  • NPI 1730831363
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245216910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WOODLAWN DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045978",
            "telephone_number": "423-975-0095",
            "fax_number": "423-928-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WOODLAWN DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045978",
            "telephone_number": "423-975-0095",
            "fax_number": "423-928-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAGEMENT CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-975-5455"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakebridge Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sulleman Malik, MD
• Anjali Malkani, M.D.
• Sameer Ahmed Mallick, MBBS
• Hailey Malone, LPN
• Haley Edwards Malone, APRN
• Nora Nery Manalo, MD
• Nicole M Mancini, DDS
• Katelyn Grace Maness
• Stephanie C Manginelli, M.D.
• Laura Kathryn Mann, DO

• Skilled Nursing Facility in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.