Active NPI
Sutherland SNF Operator LLC
- Skilled Nursing Facility
- Sutherland, IA
National Provider Identifier
1104419159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.