Yosemite Convalescent Hospital, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

YOSEMITE CONVALESCENT HOSPITAL, INC.

Doing business as

Colony Park Nursing and Rehabilitation Center

Practice address

159 E Orangeburg Ave
Modesto, CA 95350-5334

Phone

(209) 526-2811

Fax

(209) 526-6193

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Arden Bennett

Title

Ceo

Phone

(559) 673-5149

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colony Park Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033221999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 E YOSEMITE AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383343",
            "telephone_number": "559-673-5149",
            "fax_number": "559-673-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505334",
            "telephone_number": "209-526-2811",
            "fax_number": "209-526-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOSEMITE CONVALESCENT HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ARDEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-673-5149",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05849F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colony Park Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Yorba, LVN
• Danielle Corissa York, ATC
• Jonnie York, RN, PHN
• Yosemite Bone and Joint Inc (Tenaya Medical Group)
• Yosemite Community College District (Modesto Junior College)
• Yosemite Pathology Medical Group
• Yosemite Pathology Medical Group, Inc
• Yosemite Pathology Medical Group, Inc
• Derek Jacob Yoshino, BCBA
• Danielle Youhana

• Skilled Nursing Facility in Modesto, CA
• Providers in Modesto, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.