Agape Nursing & Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

AGAPE NURSING & REHABILITATION CENTER, LLC

Practice address

105 W Myrtle Ave
Johnson City, TN 37604-5633

Phone

(423) 975-5455

Fax

(423) 975-5405

NPI assigned

Jun 26, 2014

Last updated

Jan 28, 2015By 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

Mrs. Lisa M. Cawood-Gray

Title

Risk Consultant

Phone

(423) 773-4485

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1780099861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 NORTHPARK DR",
            "address_2": "SUITE 2D",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043100",
            "telephone_number": "423-975-5455",
            "fax_number": "423-975-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W MYRTLE AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045633",
            "telephone_number": "423-975-5455",
            "fax_number": "423-975-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "CAWOOD-GRAY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "RISK CONSULTANT",
        "authorized_official_telephone_number": "423-773-4485",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440618",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445019",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jake Agee
• Agilitas USA, Inc (Results Physiotherapy)
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• Agilitas USA, Inc (Results Physiotherapy)

• Skilled Nursing Facility in Johnson City, TN
• Providers in Johnson City, 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 Jan 28, 2015; 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.