SSC Greeley Centennial Operating Company LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

License

0013 Issued in CO

Legal business name

SSC GREELEY CENTENNIAL OPERATING COMPANY LLC

Practice address

1637 29TH Avenue PL
Greeley, CO 80634-6822

Phone

(970) 356-8181

Fax

(970) 356-3278

NPI assigned

Apr 10, 2018

Organization subpart

Yes

Parent organization

SSC GREELEY CENTENNIAL OPERATING COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Ken Pitts

Title

Director Reimbursement

Phone

(832) 467-6793

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Centennial Healthcare Center Doing business as

Part of

SSC Greeley Centennial Operating Company LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• SSC Greeley Centennial Operating Company LLC

  • Skilled Nursing Facility
  • Greeley, CO
  • NPI 1518087402
  NPPES parent name

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1013414796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415162",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 29TH AVENUE PL",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346822",
            "telephone_number": "970-356-8181",
            "fax_number": "970-356-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC GREELEY CENTENNIAL OPERATING COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSC GREELEY CENTENNIAL OPERATING COMPANY LLC",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "832-467-6793"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "0013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000159403",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelin Springfield, FNP-C
• Michael James Springfield, D.C., DIPL.AC.
• Blake Alexander Squier
• Matt Squires
• Rhonda Dummit Squires, PHD FNP
• SSC Greeley Centennial Operating Company LLC
• SSC Greeley Kenton Operating Company LLC
• SSC Greeley Kenton Operating Company LLC
• Samantha Stadjuhar Whitmore
• Sheldon Gregory Stadnyk, M.D.

• Respite Care in Greeley, CO
• Providers in Greeley, CO by specialty
• Respite Care in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.