NPIMap

Organization Active NPI

Sunbridge Clipper Home of Portsmouth LLC

Doing business as Clipper Harbor

  • Skilled Nursing Facility
  • Portsmouth, NH
National Provider Identifier
1093769408
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
02450 Issued in NH
Legal business name
SUNBRIDGE CLIPPER HOME OF PORTSMOUTH LLC
Doing business as
Clipper Harbor
Practice address
188 Jones Ave
Portsmouth, NH 03801-5516
Phone
(603) 431-2530
Fax
(603) 427-0507
NPI assigned
May 20, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Michael Berg
Title
Assistant Secretary
Phone
(505) 468-4742

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 02453 NH
Alzheimer Center (Dementia Center) 311500000X 02450 NH
Nursing Facility/Intermediate Care Facility 313M00000X 02450 NH
Skilled Nursing Facility 314000000X 02450 NH Primary

Addresses

Primary practice location

188 Jones Ave
Portsmouth, NH 03801-5516

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 2

IdentifierTypeStateIssuer
5BBOtherFEDERAL BC
99750159MedicaidNH

Other names 1

  • Clipper Harbor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sunrise HLTH Care Corp28 organizations share this tax ID, including this one
Part of
Sunrise HLTH Care Corp

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1093769408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 JONES AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015516",
            "telephone_number": "603-431-2530",
            "fax_number": "603-427-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE CLIPPER HOME OF PORTSMOUTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-20",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NH",
            "license": "02453",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NH",
            "license": "02450",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NH",
            "license": "02450",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NH",
            "license": "02450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC",
            "identifier": "5BB",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99750159",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clipper Harbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.