Fayette Nursing & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

48 Issued in WV

Legal business name

FAYETTE NURSING & REHABILITATION CENTER LLC

Practice address

100 Hresan Blvd
Fayetteville, WV 25840-1333

Phone

(304) 574-0770

Fax

(304) 574-1434

NPI assigned

Dec 28, 2006

Last updated

Nov 19, 2009By 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

Todd Jones

Title

Executive Vice President

Phone

(304) 344-1623

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Michael Louis Antolini

  • Family Medicine Physician
  • Fayetteville, WV
  • NPI 1851659387
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1871659730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HRESAN BLVD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401333",
            "telephone_number": "304-574-0770",
            "fax_number": "304-574-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HRESAN BLVD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401333",
            "telephone_number": "304-574-0770",
            "fax_number": "304-574-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "304-344-1623"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003077000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chloe A Farris
• Fayette County Board of Education
• Fayette County Board of Education
• Fayette County Board of Health
• Fayette Medical Services PLLC (Fayetteville Urgent Care)
• Fayetteville Physical Therapy & Sports Rehabilitation
• Fayetteville SNF LLC (Fayetteville Rehabilitation and Healthcare Center)
• Anna Fernandez
• Christy Fernandez
• Five Oaks Family Clinic, Inc.

• Skilled Nursing Facility in Fayetteville, WV
• Providers in Fayetteville, 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 Nov 19, 2009; 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.