NPIMap

Organization Active NPI

North Lake 5-O, LLC

  • Skilled Nursing Facility
  • Shoreline, WA
National Provider Identifier
1447647482
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1421 Issued in WA
Legal business name
NORTH LAKE 5-O, LLC
Practice address
2818 NE 145TH St
Shoreline, WA 98155-7556
Phone
(206) 418-2900
NPI assigned
Apr 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Brian Newberry
Title
Manager
Phone
(801) 899-5364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1421 WA Primary

Addresses

Primary practice location

2818 NE 145TH St
Shoreline, WA 98155-7556

Mailing address

2818 NE 145TH St
Shoreline, WA 98155-7556
Phone (206) 418-2900

Other names 1

  • Shoreline Health and Rehabilitation Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1447647482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 NE 145TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557556",
            "telephone_number": "206-418-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 NE 145TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557556",
            "telephone_number": "206-418-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE 5-O, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "NEWBERRY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-899-5364"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.