SSC Goldsboro Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0492 Issued in NC

Legal business name

SSC GOLDSBORO OPERATING COMPANY LLC

Doing business as

Brian Center Health & Rehabilitation - Goldsboro

Practice address

1700 Wayne Memorial Dr
Goldsboro, NC 27534-2240

Phone

(919) 731-2805

NPI assigned

Apr 1, 2007

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Brian Center Health & Rehabilitation - Goldsboro Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1104946060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342240",
            "telephone_number": "919-731-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC GOLDSBORO OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "NH0492",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0492",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804811",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3445343",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3446240",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDR eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brian Center Health & Rehabilitation - Goldsboro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brian Center Health & Rehabilitation - Goldsboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.