NPIMap

Organization Active NPI

Cedarcroft Health Services Inc

Doing business as Big Bend Woods Healthcare Center

  • Skilled Nursing Facility
  • Valley Park, MO
National Provider Identifier
1144227422
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
031222 Issued in MO
Legal business name
CEDARCROFT HEALTH SERVICES INC
Doing business as
Big Bend Woods Healthcare Center
Practice address
110 Highland Ave
Valley Park, MO 63088-1422
Phone
(636) 225-5144
Fax
(636) 225-8427
NPI assigned
Jul 1, 2005
Last updated
Jul 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Mr. Brian Reynolds
Title
Ceo
Phone
(410) 513-8738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 031222 MO Primary

Addresses

Primary practice location

110 Highland Ave
Valley Park, MO 63088-1422

Mailing address

110 Highland Ave
Valley Park, MO 63088-1422
Phone (636) 225-5144

Other identifiers 1

IdentifierTypeStateIssuer
101481901MedicaidMO

Other names 1

  • Big Bend Woods Healthcare Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BBW Management Group LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1144227422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HIGHLAND AVE",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630881422",
            "telephone_number": "636-225-5144",
            "fax_number": "636-225-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIGHLAND AVE",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630881422",
            "telephone_number": "636-225-5144",
            "fax_number": "636-225-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARCROFT HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-513-8738",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101481901",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Bend Woods Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valley Park, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.