33 Southmoor Properties, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020436 Issued in CO

Legal business name

33 SOUTHMOOR PROPERTIES, INC

Practice address

2920 Fenton St
Wheat Ridge, CO 80214-8116

Phone

(303) 238-0481

Fax

(303) 233-3775

NPI assigned

Jan 25, 2016

Organization subpart

No

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

Authorized official

Name

Mary Koretke

Title

Director of Reimbursement

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wheatridge Manor Care Center Doing business as

Tax ID family

33 Southmoor Properties Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 33 Southmoor Properties, Inc.

  • Skilled Nursing Facility
  • Wheat Ridge, CO
  • NPI 1902803620
  NPD tax ID

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1124485933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 FENTON ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "802148116",
            "telephone_number": "303-238-0481",
            "fax_number": "303-233-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FENTON ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "802148116",
            "telephone_number": "303-238-0481",
            "fax_number": "303-233-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "33 SOUTHMOOR PROPERTIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34376020",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheatridge Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 1 Above the Rest
• 1918 Winter Street Operating Co LLC
• 1Plus Home Care LLC
• 33 Southmoor Properties, Inc.
• 3510 Holland Management LLC
• 9495 W 49TH Avenue LLC
• A Bigger Boat, LLC
• A Brighter Community LLC

• Skilled Nursing Facility in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.