1248 Hospital Drive Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

1248 HOSPITAL DRIVE OPERATIONS LLC

Doing business as

St. Johnsbury Health and Rehabilitation Center

Practice address

1248 Hospital Drive
St. Johnsbury, VT 05819

Phone

(802) 748-8757

Fax

(802) 748-8758

NPI assigned

Aug 5, 2015

Last updated

Aug 10, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

SUMMIT CARE LLCAs reported in NPPES

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

Authorized official

Name

Michael T Berg

Title

Assistant Secretary

Phone

(505) 468-4742

Specialties & licenses 1

Addresses

Other names 1

• St. Johnsbury Health and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1306222989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 HOSPITAL DRIVE",
            "city": "ST. JOHNSBURY",
            "state": "VT",
            "postal_code": "05819",
            "telephone_number": "802-748-8757",
            "fax_number": "802-748-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 HOSPITAL DRIVE",
            "city": "ST. JOHNSBURY",
            "state": "VT",
            "postal_code": "05819",
            "telephone_number": "802-748-8757",
            "fax_number": "802-748-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1248 HOSPITAL DRIVE OPERATIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2015-08-05",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Johnsbury Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 1248 Hospital Drive Opco LLC (st johnsbury center for living and rehabilitation)
• Jacqueline Abella, PT
• Neil Edward Medina Abella
• Cynthia Anne Abry, LCMHC
• Anna Elizabeth Acito
• Amanda Rose Addeo, LCMHC

• Skilled Nursing Facility in St Johnsbury, VT
• Providers in St Johnsbury, VT by specialty
• Skilled Nursing Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.