Park Ridge Healthcare SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

62219 Issued in NJ

Legal business name

PARK RIDGE HEALTHCARE SNF, LLC

Doing business as

The Plaza Regency at Park Ridge

Practice address

120 Noyes Dr
Park Ridge, NJ 07656-1294

Phone

(201) 505-1777

NPI assigned

Sep 21, 2005

Organization subpart

No

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

Authorized official

Name

Kathleen Martin

Title

Lnha

Phone

(201) 505-1777

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• The Plaza Regency at Park Ridge Doing business as

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306832779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NOYES DR",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561294",
            "telephone_number": "201-505-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NOYES DR",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561294",
            "telephone_number": "201-505-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE HEALTHCARE SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "LNHA",
        "authorized_official_telephone_number": "201-505-1777"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "62219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60010170",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC/BS (SUBACUTE)",
            "identifier": "001006",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC/BS (SKILLED)",
            "identifier": "315438",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (HMO)",
            "identifier": "3226705",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID",
            "identifier": "108331",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCHOICE OF NJ",
            "identifier": "18406",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA (TRADITIONAL)",
            "identifier": "7399349",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7667302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Plaza Regency at Park Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Park Ridge, NJ
• Providers in Park Ridge, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.