NPIMap

Organization Active NPI

Lutheran Home - Hickory West

  • Skilled Nursing Facility
  • Hickory, NC
National Provider Identifier
1124202759
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NC0162 Issued in NC
Legal business name
LUTHERAN HOME - HICKORY WEST
Practice address
1125 10TH Street Blvd NW
Hickory, NC 28601-3373
Phone
(828) 322-6995
Fax
(828) 485-0070
NPI assigned
Dec 18, 2007
Last updated
Feb 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Authorized official

Name
Mr. Gus Flaska
Title
Administrator
Phone
(828) 322-6995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NC0162 NC Primary

Addresses

Primary practice location

1125 10TH Street Blvd NW
Hickory, NC 28601-3373

Mailing address

1125 10TH Street Blvd NW
Hickory, NC 28601-3373
Phone (828) 322-6995

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Home - Hickory West3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1124202759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 10TH STREET BLVD NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013373",
            "telephone_number": "828-322-6995",
            "fax_number": "828-485-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 10TH STREET BLVD NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013373",
            "telephone_number": "828-322-6995",
            "fax_number": "828-485-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME - HICKORY WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "FLASKA",
        "authorized_official_first_name": "GUS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-322-6995",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NC0162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.