Pinecrest Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PINECREST CARE CENTER LLC

Practice address

1020 Pine St
Humboldt, KS 66748-1960

Phone

(620) 473-2393

NPI assigned

Jan 27, 2011

Last updated

Jan 27, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

DNR TWO, LLCAs reported in NPPES

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

Authorized official

Name

Shauna Robertson

Title

Manager

Phone

(801) 296-5105

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1376849174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MARKET PLACE DR",
            "address_2": "SUITE 203",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141708",
            "telephone_number": "801-296-5105",
            "fax_number": "801-382-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 PINE ST",
            "city": "HUMBOLDT",
            "state": "KS",
            "postal_code": "667481960",
            "telephone_number": "620-473-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST CARE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DNR TWO, LLC",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-296-5105"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M. Sean McReynolds, DDS, LLC
• Michael Sean McReynolds, D.D.S.
• Hunter Gage Murrow, DPT
• Mallory Naff, DPT
• Neosho Memorial Regional Medical Center (Nmrmc Family Medicine Clinic - Humboldt)
• Todd Rogers
• Saint Luke's Hospital of Allen County, Inc
• Kristina Sirimarco
• Robert Newton Smith, O.D.
• Southeast Kansas Mental Health Center (Ashley Clinic)

• Skilled Nursing Facility in Humboldt, KS
• Providers in Humboldt, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.