Essential Access Healthcare, LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

ESSENTIAL ACCESS HEALTHCARE, LLC

Practice address

200 Rowland Drive
Bridgeport, AL 35740

Phone

(256) 695-4495

NPI assigned

Dec 13, 2022

Last updated

Dec 13, 2022By 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

Phil Rowland

Title

Ceo

Phone

(423) 508-8837

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336850163. Details of each certification follow.

• CCN 014019 Hospital · Active · Details

Hospital certification: CCN 014019

Legal name

ESSENTIAL ACCESS HEALTHCARE, LLC

Doing business as

CREEKSIDE HOSPITAL

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

May 1, 2024

Last certification

Mar 6, 2024

Beds

21

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Incorporated

May 28, 2004 in TN

Enrollment address

200 Rowland Drive
Bridgeport, TN 35740
Main/Primary Hospital Location

Hospital subgroups

Psychiatric

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 3

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.

• Rachel Lauren Pope, M.D.

  • Psychiatry Physician
  • Guntersville, AL
  • NPI 1558505966
  Medicare reassignment NPD
• Sarath Gangavarapu, MD

  • Psychiatry Physician
  • Columbia, TN
  • NPI 1194755124
  Medicare reassignment NPD
• Shankar B Yalamanchili, M.D.

  • Psychiatry Physician
  • Birmingham, AL
  • NPI 1558332569
  NPD (past)

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1336850163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 MAGNOLIA VALE DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374192186",
            "telephone_number": "423-304-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROWLAND DRIVE",
            "city": "BRIDGEPORT",
            "state": "AL",
            "postal_code": "35740",
            "telephone_number": "256-695-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL ACCESS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-508-8837"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Hospital in Bridgeport, AL
• Providers in Bridgeport, AL by specialty
• Psychiatric Hospital in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.