Lightning Creek Investment Group,Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

034138 Issued in MO

Legal business name

LIGHTNING CREEK INVESTMENT GROUP,INC

Practice address

721 W Harrison St
Brunswick, MO 65236

Phone

(660) 548-3182

Fax

(660) 548-3813

NPI assigned

Oct 28, 2005

Organization subpart

No

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

Authorized official

Name

Julie M Reichert, RN ADMINISTRATOR

Title

Administrator

Phone

(660) 548-3182

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brunswick Nursing Home Doing business as

Locations

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1265422331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W HARRISON ST",
            "city": "BRUNSWICK",
            "state": "MO",
            "postal_code": "65236",
            "telephone_number": "660-548-3182",
            "fax_number": "660-548-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W HARRISON ST",
            "city": "BRUNSWICK",
            "state": "MO",
            "postal_code": "65236",
            "telephone_number": "660-548-3182",
            "fax_number": "660-548-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTNING CREEK INVESTMENT GROUP,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "REICHERT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-548-3182",
        "authorized_official_credential": "RN ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "034138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102272101",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brunswick Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Elizabeth Hamilton, LPTA
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• Jukeco Enterprises LLC
• Margaret J Larson, SLP
• Trent Link, FNP
• Nancy J Lock
• Paige McHugh
• Lindsay Dyan Meyer, OTA
• Sandra L. Moser, FNP

• All providers in Brunswick, MO
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.