Active NPI
Five Star Quality Care-Colorado LLC
Doing business as Skyline Ridge Apartments and Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Canon City, CO
National Provider Identifier
1255386546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1091
- Legal business name
- FIVE STAR QUALITY CARE-COLORADO LLC
- Doing business as
- Skyline Ridge Apartments and Nursing & Rehabilitation Center
- Practice address
- 515 Fairview Ave
Canon City, CO 81212-2863 - Phone
- (719) 275-0665
- Fax
- (719) 275-6225
- NPI assigned
- May 24, 2006
- Last updated
- Mar 26, 2019
- Organization subpart
- Yes
- Parent organization
- FIVE STAR QUALITY CARE-COLORADO LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katerine E Potter
- Title
- President & Chief Executive Officer
- Phone
- (617) 796-8387
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1091 | CO | Primary |
Addresses
Primary practice location
515 Fairview Ave
Canon City, CO 81212-2863
Mailing address
400 Centre St
Newton, MA 02458-2094
Phone (617) 796-8387
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 72008041 | Medicaid | CO |
Other names 1
- Skyline Ridge Apartments and Nursing & Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Five Star Quality Care-Colorado LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553558400000",
"number": "1255386546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CENTRE ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024582094",
"telephone_number": "617-796-8387",
"fax_number": "617-796-8375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 FAIRVIEW AVE",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122863",
"telephone_number": "719-275-0665",
"fax_number": "719-275-6225"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
"enumeration_date": "2006-05-24",
"last_updated": "2019-03-26",
"status": "A",
"authorized_official_last_name": "POTTER",
"authorized_official_first_name": "KATERINE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "617-796-8387"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CO",
"license": "1091",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "72008041",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Skyline Ridge Apartments and Nursing & Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Canon City, CO
- Crystal Euceda
- David Fairman, PNMT, LMT, CMLDT
- Monika Farkas, MSW
- Felicia Ann James
- Richard E Fenn, CRNA
- Five Star Quality Care-Colorado LLC (Skyline Ridge Nursing & Rehab)
- Flanagan Speech Services Corp
- Winifred Louise Flanagan, SLP-CCC
- Tracy Ann Fontecchio, RN
- Foot and Ankle Specialists of Colorado PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.