Lakebridge a Waters Community LLC
NPI 1043763592 · Skilled Nursing Facility · Johnson City, TN
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lakebridge a Waters Community LLC is a Skilled Nursing Facility organization in Johnson City, TN (NPI 1043763592).
Provider details
- NPI number
- 1043763592
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Moishe Gubin, Member(708) 449-1900
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-08-02
- Last updated
- 2016-08-02
Frequently asked questions
- What is Lakebridge a Waters Community LLC's NPI number?
- Lakebridge a Waters Community LLC's National Provider Identifier (NPI) is 1043763592, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakebridge a Waters Community LLC?
- Lakebridge a Waters Community LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Lakebridge a Waters Community LLC located?
- Lakebridge a Waters Community LLC's practice location on file with NPPES is 115 Woodlawn Dr, Johnson City, TN 37604-5978.
- What is Lakebridge a Waters Community LLC's phone number?
- The practice phone number listed in the NPPES registry for Lakebridge a Waters Community LLC is (423) 975-0095.
- Does Lakebridge a Waters Community LLC accept Medicare?
- Lakebridge a Waters Community LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lakebridge a Waters Community LLC?
- The authorized official listed on Lakebridge a Waters Community LLC's NPPES record is Moishe Gubin, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakebridge a Waters Community LLC's NPI active?
- Yes — Lakebridge a Waters Community LLC's NPI (1043763592) is active in the NPPES registry as of the last update on 2016-08-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.