Berthold Nursing Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

040704 Issued in MO

Legal business name

BERTHOLD NURSING CENTER INC

Practice address

6637 Berthold Ave
Saint Louis, MO 63139-3318

Phone

(314) 781-3444

Fax

(314) 781-6139

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Cliff Shirrell

Title

Vice President

Phone

(573) 471-1276

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oak Park Nursing Center Doing business as

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1407888407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N MAIN ST",
            "address_2": "P.O. BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012151",
            "telephone_number": "573-471-1276",
            "fax_number": "573-472-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 BERTHOLD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393318",
            "telephone_number": "314-781-3444",
            "fax_number": "314-781-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHOLD NURSING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "SHIRRELL",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "040704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102561503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Park Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abby Bert, MS, RDN
• Ana Bertanjoli
• Chelsea Bertelsmann, MS, RD, LD
• Jill Marie Bertelsmeyer
• Amy D Bertelson, PHD
• Daniel Bertilson, LPC
• Theresa Bertin, FNP
• Gerry J Bertish, PA
• Lauren Bertoy, MD
• Tracey Bertram, MD

• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.