Atchison Enterprises Incorporated

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

331949 Issued in MN

Legal business name

ATCHISON ENTERPRISES INCORPORATED

Doing business as

South Shore Care Center

Practice address

1307 S Shore Dr
Worthington, MN 56187-1344

Phone

(507) 376-3175

Fax

(507) 376-9042

NPI assigned

Jul 3, 2006

Last updated

May 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara M Atchison

Title

Administrator

Phone

(507) 376-3175

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Shore Care Center Doing business as

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1225068588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561870069",
            "telephone_number": "507-376-3175",
            "fax_number": "507-376-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S SHORE DR",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871344",
            "telephone_number": "507-376-3175",
            "fax_number": "507-376-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATCHISON ENTERPRISES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "ATCHISON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-376-3175"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "331949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9512LA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201042900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Shore Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.