Eagle Acquisition VIII LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EAGLE ACQUISITION VIII LLC

Doing business as

Concordia Nursing and Rehabilitation - Fairpark

Practice address

307 N 5TH St
Maryville, TN 37804-2921

Phone

(865) 983-0261

Fax

(865) 984-5108

NPI assigned

Aug 3, 2017

Last updated

Jul 21, 2022By 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

Bent Philipson

Title

Managing Member

Phone

(865) 983-0261

Specialties & licenses 1

Addresses

Other names 1

• Concordia Nursing and Rehabilitation - Fairpark Doing business as

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.

• Amanda Jean Bivens, OTR/L

  • Occupational Therapist
  • Maryville, TN
  • NPI 1194989780
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962927616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5477",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025477",
            "telephone_number": "865-983-0261",
            "fax_number": "865-984-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 N 5TH ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378042921",
            "telephone_number": "865-983-0261",
            "fax_number": "865-984-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ACQUISITION VIII LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHILIPSON",
        "authorized_official_first_name": "BENT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "865-983-0261"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concordia Nursing and Rehabilitation - Fairpark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Ross Durand, M.D.
• Larry J Durand, DMD
• Ashley Faye Durbin, LMT
• Roland T Dykes
• Bonnie Jo Dziesinski, PA
• Eagle Acquisition X LLC (Concordia Transitional Care and Rehabilitation - Maryville)
• Allison Earley, MMFT
• Randi J Earley
• East Tennessee Addiction Specialists
• East Tennessee Clinic of Chiropractic

• Skilled Nursing Facility in Maryville, TN
• Providers in Maryville, 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 Jul 21, 2022; 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.