Countryside Convalescent Home Limited Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COUNTRYSIDE CONVALESCENT HOME LIMITED PARTNERSHIP

Practice address

8221 Lamor Rd
Mercer, PA 16137-3163

Phone

(724) 431-0770

Fax

(724) 431-0764

NPI assigned

Sep 6, 2005

Last updated

Aug 14, 2014By 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

Steven D Tack, NHA

Title

Ceo

Phone

(724) 431-0770

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jarod Paul Stragand, D.O.

  • Family Medicine Physician
  • Beaver Falls, PA
  • NPI 1235353848
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1376537431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 LAMOR RD",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161373163",
            "telephone_number": "724-431-0770",
            "fax_number": "724-431-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 LAMOR RD",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161373163",
            "telephone_number": "724-431-0770",
            "fax_number": "724-431-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE CONVALESCENT HOME LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "TACK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-431-0770",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012990090001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC",
            "identifier": "1121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "263249",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HP",
            "identifier": "1501006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "305354",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CMPT Associates (Mercer Physical Therapy)
• Gavin Colligan
• Cool Springs Physical Therapy
• Cornerstone Community Counseling, LLC.
• Jennifer Ann Coughlin, D.O.
• Countryside Convalescent Home Limited Partnership
• Connie Cousins, CRNA
• Davis Chiropractic Clinic, P.C.
• Richard E Davis, D.C.
• Kayla Marie Dehus

• Skilled Nursing Facility in Mercer, PA
• Providers in Mercer, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.