Sunbridge Jeff Davis Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10801485 Issued in GA

Legal business name

SUNBRIDGE JEFF DAVIS HEALTHCARE LLC

Doing business as

Hazelhurst Court Care and Rehabilitation Center

Practice address

180 Burketts Ferry Rd
Hazlehurst, GA 31539-7132

Phone

(912) 375-3677

Fax

(912) 375-9974

NPI assigned

May 13, 2006

Last updated

Jan 6, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

William A. Mathies

Title

President Director

Phone

(505) 821-3355

Specialties & licenses 1

Addresses

Other names 1

• Hazelhurst Court Care and Rehabilitation 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 Healthcare LLC

  dba Cottage of the Shoals

  • Skilled Nursing Facility
  • Tuscumbia, AL
  • NPI 1285685362

  Member Of

  NPD member
• Sunbridge Retirement Care Associates LLC

  dba Pembroke Care and Rehabilitation Center

  • Skilled Nursing Facility
  • Pembroke, NC
  • NPI 1194779504

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1891746889",
    "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": "180 BURKETTS FERRY RD",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315397132",
            "telephone_number": "912-375-3677",
            "fax_number": "912-375-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE JEFF DAVIS HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10801485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazelhurst Court Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cara Taylor, RN, MSN
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• Tony Sparks, LLC Dba Hazlehurst Pediatrics

• Skilled Nursing Facility in Hazlehurst, GA
• Providers in Hazlehurst, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.