Lakebridge A Waters Community LLC
NPI 1043763592ActiveOrganization· Skilled Nursing Facility· Johnson City, TN
Skilled Nursing Facility in Johnson City, Tennessee, registered in NPPES in August 2016. The authorized official on file is Moishe Gubin, Member. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1043763592 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 2, 2016 |
| Last updated in NPPES | Aug 2, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (TN) |
|---|
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