City of Adrian - Adrian Manor Health and Rehab

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030454 Issued in MO

Legal business name

CITY OF ADRIAN - ADRIAN MANOR HEALTH AND REHAB

Practice address

402 W 1St St
Adrian, MO 64720-9998

Phone

(816) 297-2107

Fax

(816) 297-4321

NPI assigned

Jun 22, 2006

Last updated

Jan 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Douglas G Fredrickson

Title

Administrator

Phone

(816) 297-2107

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1124054366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W 1ST ST",
            "city": "ADRIAN",
            "state": "MO",
            "postal_code": "647209998",
            "telephone_number": "816-297-2107",
            "fax_number": "816-297-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W 1ST ST",
            "city": "ADRIAN",
            "state": "MO",
            "postal_code": "647209998",
            "telephone_number": "816-297-2107",
            "fax_number": "816-297-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ADRIAN - ADRIAN MANOR HEALTH AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "FREDRICKSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "816-297-2107",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Adrian, MO
• Providers in Adrian, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.