Lincoln County Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

20 Issued in ID

Legal business name

LINCOLN COUNTY CARE CENTER LLC

Practice address

511 E 4TH St
Shoshone, ID 83352-5380

Phone

(208) 886-2228

Fax

(208) 886-2549

NPI assigned

Sep 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. James B Everton

Title

Ceo

Phone

(208) 233-4673

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1124335476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S 5TH AVE",
            "address_2": "LOWER LEVEL",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016400",
            "telephone_number": "208-233-4673",
            "fax_number": "208-233-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E 4TH ST",
            "city": "SHOSHONE",
            "state": "ID",
            "postal_code": "833525380",
            "telephone_number": "208-886-2228",
            "fax_number": "208-886-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "EVERTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-233-4673",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine Hawkes
• Katie S Hays, LCSW
• Keith E Davis
• Matthew E. Kent, O.D.
• Lincoln Community Health
• Lincoln County EMS
• Lincoln County EMS
• Andrea Madson, LMSW
• Matthew E. Kent, O.D.,P.a.
• Physician Management Services of Idaho, LLC

• All providers in Shoshone, ID
• Skilled Nursing Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.