Wyndridge TN Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WYNDRIDGE TN OPCO LLC

Practice address

456 Wayne Ave
Crossville, TN 38555-4206

Phone

(931) 484-6129

NPI assigned

Mar 23, 2021

Organization subpart

No

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

Authorized official

Name

Isaac Moskowitz

Title

Manager

Phone

(212) 444-1991

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1356927016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 37TH ST STE 605",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184382",
            "telephone_number": "646-649-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554206",
            "telephone_number": "931-484-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDRIDGE TN OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "MOSKOWITZ",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-444-1991"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke K Wright, CPNP
• Larry Shane Wyatt, LPC
• Madeline Wyatt, PT
• Mary Brooke Tackett Wyatt, PA
• Wyndridge Health Systems
• Ashley Elizabeth Young, RN
• Brant R Young, PHARMD
• William M. Young, M.D..
• Zander Dentistry PLLC
• Jeraldine A Ziegele, LPC/MHSP

• Skilled Nursing Facility in Crossville, TN
• Providers in Crossville, 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 Mar 23, 2021; 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.