NPIMap

Organization Active NPI

Crete Area Mecical Center LTC

  • Adult Care Home Facility
  • Crete, NE
National Provider Identifier
1104815778
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
LTCH009 Issued in NE
Legal business name
CRETE AREA MECICAL CENTER LTC
Practice address
1540 Grove Ave
Crete, NE 68333-1749
Phone
(402) 826-6867
Fax
(402) 826-6827
NPI assigned
Oct 17, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Carol Kohles, RN
Title
Don/Asst. Adm
Phone
(402) 826-6805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X LTCH009 NE Primary

Addresses

Primary practice location

1540 Grove Ave
Crete, NE 68333-1749

Mailing address

1540 Grove Ave
PO Box 220
Crete, NE 68333-1749
Phone (402) 826-6867

National Provider Directory

National Provider Directory
Tax ID family
Crete Area Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104815778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 GROVE AVE",
            "address_2": "PO BOX 220",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683331749",
            "telephone_number": "402-826-6867",
            "fax_number": "402-826-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 GROVE AVE",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683331749",
            "telephone_number": "402-826-6867",
            "fax_number": "402-826-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRETE AREA MECICAL CENTER LTC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOHLES",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "DON/ASST. ADM",
        "authorized_official_telephone_number": "402-826-6805",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NE",
            "license": "LTCH009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

  • 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.