Glenbridge Health and Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0400 Issued in NC

Legal business name

GLENBRIDGE HEALTH AND REHABILITATION CENTER, LLC

Practice address

211 Milton Brown Heirs Rd
Boone, NC 28607-8708

Phone

(828) 264-6720

Fax

(828) 264-9023

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Nielson, MBA

Title

Managing Member

Phone

(407) 247-2788

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1477511079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MILTON BROWN HEIRS RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286078708",
            "telephone_number": "828-264-6720",
            "fax_number": "828-264-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MILTON BROWN HEIRS RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286078708",
            "telephone_number": "828-264-6720",
            "fax_number": "828-264-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENBRIDGE HEALTH AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "NIELSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "407-247-2788",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3445163",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3436539",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Styers Gilbert, PA-C
• Sarah Ashley Gill, ATC
• Westin Gillis, LCMHC-A
• Lauren Ginocchio, LAT, ATC, CISSN
• Lynda Gioia-Flynt, MD
• Glenbridge Health and Rehabiltation SNF LLC
• Daniel James Goble, M.D.
• Wanda Lee Godfrey, MD
• Herman A. Godwin Jr., M.D
• Hannah Goedrich, PA-C

• All providers in Boone, NC
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.