Sunbridge Mountain Care Management LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

99 Issued in WV

Legal business name

SUNBRIDGE MOUNTAIN CARE MANAGEMENT LLC

Doing business as

New Martinsville Center

Practice address

225 Russell Ave
New Martinsville, WV 26155-1572

Phone

(304) 455-2600

Fax

(304) 455-2580

NPI assigned

May 30, 2006

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

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

Authorized official

Name

Michael Berg

Title

Assistant Secretary

Phone

(505) 468-4742

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• New Martinsville Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Terrace Hghts Nursing H

Member of 2

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

• Sunbridge Care Enterprises LLC

  dba Parkersburg Center

  • Skilled Nursing Facility
  • Parkersburg, WV
  • NPI 1932199007

  Member Of

  NPD member
• Sunbridge Healthcare LLC

  dba Cottage of the Shoals

  • Skilled Nursing Facility
  • Tuscumbia, AL
  • NPI 1285685362

  Member Of

  NPD member

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1689621062",
    "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": "225 RUSSELL AVE",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261551572",
            "telephone_number": "304-455-2600",
            "fax_number": "304-455-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE MOUNTAIN CARE MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-30",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WV",
            "license": "99",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015198000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001703864",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Martinsville Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Stillwagner
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• Shelby Lynn Storm, MA, CCC-SLP
• Breauna Danielle Streets
• Cody N Sturm
• Sidney Williams Sustarich
• Brian Lee Suter
• Paula Swartzmiller, MA LPC
• Brian Taylor
• Barbara Jean Theodoro, LSW

• Skilled Nursing Facility in New Martinsville, WV
• Providers in New Martinsville, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.