Oak Terrace Health Care Center of Gaylord ,LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

335464 Issued in MN

Legal business name

OAK TERRACE HEALTH CARE CENTER OF GAYLORD ,LLC

Practice address

640 3Rd St
Gaylord, MN 55334-2297

Phone

(507) 237-2911

Fax

(507) 237-5744

NPI assigned

Sep 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael David Montag, OWNER

Title

Owner

Phone

(507) 381-1312

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1189814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1285820092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 TOWER BLVD",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560032520",
            "telephone_number": "507-387-2037",
            "fax_number": "507-387-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 3RD ST",
            "city": "GAYLORD",
            "state": "MN",
            "postal_code": "553342297",
            "telephone_number": "507-237-2911",
            "fax_number": "507-237-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TERRACE HEALTH CARE CENTER OF GAYLORD ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-15",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "MONTAG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-381-1312",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "335464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Gaylord, MN
• Providers in Gaylord, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.