NPIMap

Organization Active NPI

Chestertown Operator LLC

  • Skilled Nursing Facility
  • Chestertown, MD
National Provider Identifier
1003222944
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
14006 Issued in MD
Legal business name
CHESTERTOWN OPERATOR LLC
Practice address
415 Morgnec Rd
Chestertown, MD 21620-1046
Phone
(410) 778-1900
NPI assigned
Jul 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(877) 567-0402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 14006 MD Primary
Respite Care 385H00000X

Addresses

Primary practice location

415 Morgnec Rd
Chestertown, MD 21620-1046

Mailing address

14C 53Rd St Ste 224N
Brooklyn, NY 11232-2644
Phone (718) 567-0400

Other names 1

  • Autumn Lake Healthcare At Chestertown Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1003222944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 224N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "718-567-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORGNEC RD",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201046",
            "telephone_number": "410-778-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERTOWN OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "14006",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare At Chestertown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Autumn Lake Healthcare At Chestertown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.