Smith Ranch Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

010000411 Issued in CA

Legal business name

SMITH RANCH CARE CENTER, LLC

Practice address

1550 Silveira Pkwy
San Rafael, CA 94903-4879

Phone

(415) 499-1000

Fax

(415) 499-4136

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn A. Weaver

Title

Assistant Secretary

Phone

(502) 596-7563

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kindred Transitional Care and Rehabilitation-Smith Ranch Doing business as

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1417977299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S. 4TH STREET",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-7301",
            "fax_number": "502-596-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SILVEIRA PKWY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034879",
            "telephone_number": "415-499-1000",
            "fax_number": "415-499-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH RANCH CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7563",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "010000411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N/A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Transitional Care and Rehabilitation-Smith Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Smart, RN
• Peter Joseph Smead
• Brenda Lee Smeeth
• Fiona Smeltzer
• Smith Bio Medical Inc
• Virginia Ann Smith-Bronstein, M.D.
• Alana Smith-Grove, AMFT
• Brianna Smith, PTA
• Bryan Smith, CADC II
• Candice Smith

• Skilled Nursing Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.