Sunbridge Charlton Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10241484 Issued in GA

Legal business name

SUNBRIDGE CHARLTON HEALTHCARE LLC

Doing business as

Folkston Park Care and Rehabilitation Center

Practice address

36261 Okefenokee Dr
Folkston, GA 31537-7853

Phone

(912) 496-7396

Fax

(912) 496-2087

NPI assigned

May 13, 2006

Last updated

Jun 11, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 1

• Folkston Park Care and Rehabilitation Center Doing business as

Part of

Sunrise HLTH Care Corp

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Sunbridge Healthcare LLC

  dba Columbia Crest Center

  • Skilled Nursing Facility
  • Moses Lake, WA
  • NPI 1982651758

  Member Of

  NPD member
• Sunbridge Retirement Care Associates LLC

  dba Pembroke Care and Rehabilitation Center

  • Skilled Nursing Facility
  • Pembroke, NC
  • NPI 1194779504

  Member Of

  NPD member

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276214400000",
    "number": "1265483259",
    "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": "36261 OKEFENOKEE DR",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315377853",
            "telephone_number": "912-496-7396",
            "fax_number": "912-496-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE CHARLTON HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-06-11",
        "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": "10241484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00141006A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Folkston Park Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandi Robertson
• Robin C Rogers, MSN,FNP-BC,ANP,RN
• Carla Jeanette Rowe, FNP-BC
• Shuman Health Care (Shuman HealthCare of Folkston)
• Kylie Sparks, NP
• T Hoffler Enterprises Inc
• Taylor Pharmacy Group, Inc. (Folkston Pharmacy)
• Jillian Brooke Taylor, PHARMD
• Donna Kay Thompson-Lisiecki, LPC
• Albert Marion Thompson Jr., MD

• Skilled Nursing Facility in Folkston, GA
• Providers in Folkston, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; 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.