Bennington Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BENNINGTON CARE CENTER, LLC

Doing business as

MissionCare at Bennington

Practice address

2 Blackberry LN
Bennington, VT 05201-2300

Phone

(802) 442-8525

NPI assigned

Nov 9, 2023

Last updated

Nov 9, 2023By 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

Chris S Wright

Title

Manager

Phone

(860) 570-2140

Specialties & licenses 1

Addresses

Other names 1

• MissionCare at Bennington Doing business as

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922872944. Details of each certification follow.

• CCN 475027B Skilled nursing facility · Details

Skilled nursing facility certification: CCN 475027B

Legal name

BENNINGTON CARE CENTER, LLC

Doing business as

MISSIONCARE AT BENNINGTON

Organization structure

LLCProprietary

Enrollment address

2 Blackberry LN
Bennington, VT 05201-2300

Nursing home name

BENNINGTON HEALTH & REHAB

Affiliated entity

ICARE HEALTH NETWORK

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jesper Brickley, DO

  • Family Medicine Physician
  • Townshend, VT
  • NPI 1194081737

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Bidwell Care Center LLC

  dba Touchpoints at Manchester

  • Skilled Nursing Facility
  • Manchester, CT
  • NPI 1790843100

  Plaza Investment Trust

  CMS ownership

Practitioners 20

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.

• Jesper Brickley, DO

  • Family Medicine Physician
  • Townshend, VT
  • NPI 1194081737
  NPD (past)
• Kelly S. Barlow, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1235498080
  NPD (past)
• Alexa A Chapman, NP

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1629472840
  NPD (past)
• Daphney Denieuse Claude

  • Acute Care Nurse Practitioner
  • New York, NY
  • NPI 1063974129
  NPD (past)
• Joelle Dangerfield, MSN, ARNP, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Jacksonville, FL
  • NPI 1962974592
  NPD (past)
• Kasra Djalayer, MD

  • Internal Medicine Physician
  • Franconia, NH
  • NPI 1093816761
  NPD (past)
• Antoaneta Angelova Fitzpatrick

  • Family Nurse Practitioner
  • McLean, VA
  • NPI 1679190441
  NPD (past)
• Alison Lynn Gettman, ARNP

  • Adult Health Nurse Practitioner
  • Port Orange, FL
  • NPI 1760665855
  NPD (past)
• Ashley C Hughes, FNP-BC, PMHNP- BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cornelius, NC
  • NPI 1083000954
  NPD (past)
• George M Kokolski Jr., DO

  • Internal Medicine Physician
  • Williamsburg, VA
  • NPI 1275590879
  NPD (past)
• Aji Kurian, PA

  • Physician Assistant
  • Houston, TX
  • NPI 1194713610
  NPD (past)
• Chester G Laskowski, M.D.

  • Family Medicine Physician
  • Lakemoor, IL
  • NPI 1508856550
  NPD (past)

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1922872944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 BIDWELL ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406470",
            "telephone_number": "860-570-2140",
            "fax_number": "860-570-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BLACKBERRY LN",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052012300",
            "telephone_number": "802-442-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNINGTON CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-570-2140"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MissionCare at Bennington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Bemak, LCMHC
• Roberta Karibo Bennett, M.D.
• Bennington Associates in Internal Medicine
• Bennington Behavioral Health PLLC
• Bennington Cardiology PC
• Bennington College Corporation
• Bennington College Health Services
• Bennington College Psychological Services
• Bennington Dental Center PC
• Bennington Family Practice PLLC

• Skilled Nursing Facility in Bennington, VT
• Providers in Bennington, VT by specialty
• Skilled Nursing Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.