Cogburn Health & Rehabilitation-Huntsville, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

004924 Issued in AL

Legal business name

COGBURN HEALTH & REHABILITATION-HUNTSVILLE, INC.

Practice address

4010 Chris Dr SW
Huntsville, AL 35802-4189

Phone

(256) 883-8656

Fax

(251) 476-7124

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Prentiss Smith

Title

Chief Operating Officer

Phone

(251) 476-4700

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1295725877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 CHRIS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024189",
            "telephone_number": "256-883-8656",
            "fax_number": "251-476-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 CHRIS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024189",
            "telephone_number": "256-883-8656",
            "fax_number": "251-476-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGBURN HEALTH & REHABILITATION-HUNTSVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PRENTISS",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "251-476-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "004924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "004924",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.