Organization Active NPI

Sutherland SNF Operator LLC

  • Skilled Nursing Facility
  • Sutherland, IA
National Provider Identifier
1104419159
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SUTHERLAND SNF OPERATOR LLC
Practice address
506 E 4TH St
Sutherland, IA 51058-7668
Phone
(712) 446-3857
NPI assigned
Feb 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Authorized official

Name
Mr. Bruce Wertheim
Title
Sole Member
Phone
(813) 347-9453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

506 E 4TH St
Sutherland, IA 51058-7668

Mailing address

15310 Amberly Dr Ste 102
Tampa, FL 33647-2145
Phone (813) 347-9453

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1104419159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15310 AMBERLY DR STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472145",
            "telephone_number": "813-347-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E 4TH ST",
            "city": "SUTHERLAND",
            "state": "IA",
            "postal_code": "510587668",
            "telephone_number": "712-446-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTHERLAND SNF OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "WERTHEIM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "813-347-9453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sutherland, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.