Cedar City Nursing Home LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2005-NCF-9975 Issued in UT

Legal business name

CEDAR CITY NURSING HOME LLC

Practice address

411 W 1325 N
Cedar City, UT 84720-7720

Phone

(435) 586-6481

Fax

(435) 586-0363

NPI assigned

May 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Glade Hamilton

Title

Administrator

Phone

(435) 586-6481

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kolob Regional Care & Rehabilitation Doing business as

Locations

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1083671119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W 1325 N",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847207720",
            "telephone_number": "435-586-6481",
            "fax_number": "435-586-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W 1325 N",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847207720",
            "telephone_number": "435-586-6481",
            "fax_number": "435-586-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CITY NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "GLADE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "435-586-6481",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "2005-NCF-9975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870317400001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kolob Regional Care & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Cedar City, UT
• Providers in Cedar City, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.