NPIMap

Organization Active NPI

Rady Children's Hospital San Diego

Doing business as Rady Children's Convalescent Hospital

  • Skilled Nursing Facility
  • San Diego, CA
National Provider Identifier
1114091055
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RADY CHILDREN'S HOSPITAL SAN DIEGO
Doing business as
Rady Children's Convalescent Hospital
Practice address
3020 Childrens Way # Mc5019
San Diego, CA 92123-4223
Phone
(858) 966-5833
Fax
(858) 966-8558
NPI assigned
Nov 20, 2006
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
RADY CHILDREN'S HOSPITAL SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Kathleen Marie Cain Carrithers
Title
Sr VP & Chief Financial Officer
Phone
(858) 966-5824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary
Pediatric Skilled Nursing Facility 3140N1450X 080000028 CA

Addresses

Primary practice location

3020 Childrens Way # Mc5019
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5019
San Diego, CA 92123-4223
Phone (858) 966-5833

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05270GMedicaidCA

Other names 1

  • Rady Children's Convalescent Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rady Childrens Spec of SD60 organizations share this tax ID, including this one
Part of
Rady Childrens Spec of SD

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

3020 Childrens Way
#5019
San Diego, CA 92123
Phone (858) 576-5833

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1114091055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5019",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5833",
            "fax_number": "858-966-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5019",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5833",
            "fax_number": "858-966-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADY CHILDREN'S HOSPITAL SAN DIEGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADY CHILDREN'S HOSPITAL SAN DIEGO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "CAIN CARRITHERS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SR VP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "858-966-5824"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "CA",
            "license": "080000028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05270G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rady Children's Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rady Children's Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.