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PETTIGREW REHABILITATION CENTER LLC NPI 1144646274


NPI Information

NPI: 1144646274
Provider Name: PETTIGREW REHABILITATION CENTER, LLC

Doing Business As: PETTIGREW REHABILITATION CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 34D0241284

Address:
1515 W PETTIGREW ST
DURHAM, NC
ZIP 27705
Phone: (919) 286-0751
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PETTIGREW REHABILITATION CENTER, LLC is a skilled nursing facility in Durham, NC. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. PETTIGREW REHABILITATION CENTER, LLC NPI is 1144646274. The provider is registered as an organization entity type.
The provider Is Doing Business As Pettigrew Rehabilitation Center.

The provider's business location address is:

1515 W PETTIGREW ST
DURHAM, NC
ZIP 27705-821
Phone: (919) 286-0751
Fax: (919) 286-7065

The provider's authorized official is R. Mark Cronquist .
The authorized official title is Manager and has the following contact phone number (404) 574-2100.

The CLIA number assigned to this NPI record is 34D0241284 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/13/2014 and was last updated on 9/29/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing FacilityNo
2314000000XSkilled Nursing FacilityNH0119NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11144646274MEDICAIDNORTH CAROLINA
2345053MEDICARE OSCAR/CERTIFICATIONNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.