Palmetto Oakbrook Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCF-637 Issued in SC

Legal business name

PALMETTO OAKBROOK OPERATING LLC

Practice address

920 Travelers Blvd
Summerville, SC 29485-8213

Phone

(843) 875-9053

Fax

(843) 875-7334

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Toya Dunlap

Title

Administrator

Phone

(843) 875-9053

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oakbrook Health & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1205910080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 TRAVELERS BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858213",
            "telephone_number": "843-875-9053",
            "fax_number": "843-875-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 TRAVELERS BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858213",
            "telephone_number": "843-875-9053",
            "fax_number": "843-875-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO OAKBROOK OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "TOYA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-875-9053"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF-637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0923NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakbrook Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Summerville, SC
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.