SSC Pawnee City Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

594001 Issued in NE

Legal business name

SSC PAWNEE CITY OPERATING COMPANY LLC

Doing business as

Pawnee Manor

Practice address

438 12TH St
Pawnee City, NE 68420-3589

Phone

(402) 852-2975

Fax

(402) 852-2979

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pawnee Manor Doing business as

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1134240294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 12TH ST",
            "city": "PAWNEE CITY",
            "state": "NE",
            "postal_code": "684203589",
            "telephone_number": "402-852-2975",
            "fax_number": "402-852-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC PAWNEE CITY OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "594001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025244600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pawnee Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrie Ann Ramsey, PA-C
• Jessica Marie Ronnebaum, DPT
• Shaina Russell
• Beverly Smith
• Alan Smyth, PA-C
• Heather Renae Stark, PTA
• Lacey Stille
• Jamie Thorson, PTA
• Meghan Lee3 Villanueva
• George R. Voigtlander, MD

• Skilled Nursing Facility in Pawnee City, NE
• Providers in Pawnee City, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.