Organization Active NPI

Ggnsc Wilkes-Barre II LP

  • Skilled Nursing Facility
  • Wilkes Barre, PA
National Provider Identifier
1154372522
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
971402 Issued in PA
Legal business name
GGNSC WILKES-BARRE II LP
Practice address
50 N Pennsylvania Ave
Wilkes Barre, PA 18701-3503
Phone
(570) 825-3488
Fax
(570) 825-9423
NPI assigned
May 12, 2006
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
Holly A. Rasmussen-Jones
Title
Sec. of the GP
Phone
(479) 201-4835

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 971402 PA Primary

Addresses

Primary practice location

50 N Pennsylvania Ave
Wilkes Barre, PA 18701-3503

Mailing address

50 N Pennsylvania Ave
Wilkes Barre, PA 18701-3503
Phone (570) 825-3488

Other identifiers 5

IdentifierTypeStateIssuer
101558613MedicaidPA
000000130630OtherPATHREE RIVERS HEALTH PLAN
1015586130001MedicaidPA
30946OtherPAGEISINGER HEALTH PLAN
1526893OtherPAGATEWAY HEALTH PLAN

Other names 1

  • Golden LivingCenter - Summit Doing business as

National Provider Directory

National Provider Directory

Locations

50 N Pennsylvania Ave
Wilkes Barre, PA 18701
Phone (570) 525-3488

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1154372522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013503",
            "telephone_number": "570-825-3488",
            "fax_number": "570-825-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013503",
            "telephone_number": "570-825-3488",
            "fax_number": "570-825-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GGNSC WILKES-BARRE II LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN-JONES",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SEC. OF THE GP",
        "authorized_official_telephone_number": "479-201-4835"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "971402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101558613",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS HEALTH PLAN",
            "identifier": "000000130630",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015586130001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "30946",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1526893",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden LivingCenter - Summit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

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.