SSC Flint Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

254250 Issued in MI

Legal business name

SSC FLINT OPERATING COMPANY LLC

Doing business as

Heritage Manor Helathcare Center

Practice address

G3201 Beecher Rd
Flint, MI 48532-3615

Phone

(810) 732-9200

Fax

(810) 732-4855

NPI assigned

Jun 14, 2006

Last updated

Nov 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other names 1

• Heritage Manor Helathcare Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1356384580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "862-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3201 BEECHER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323615",
            "telephone_number": "810-732-9200",
            "fax_number": "810-732-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC FLINT OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "254250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDR eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heritage Manor Helathcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Manor Helathcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Sprinkle, FNP-C
• Srinivas B. Mukkamala. M.D., P.L.C.
• Ranjini Srinivasan, M.D.
• Siva Kumar Sripada, DO
• Ajay Kumar Srivastava, MD
• St John Chiropractic Clinic
• Jessica St John, LLBSW, CMHP, QMHP
• Dan St. Aubin, M.D.
• Rebecca St. James, MSW
• Katharine Nicole St. John, B.A., QMHP

• Skilled Nursing Facility in Flint, MI
• Providers in Flint, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.