Stockton Nursing and Rehab Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

STOCKTON NURSING AND REHAB CENTER LLC

Doing business as

Stockton Nursing Center

Practice address

4545 Shelley CT
Stockton, CA 95207-7232

Phone

(801) 601-1450

NPI assigned

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Brooke Hixson

Title

Controller

Phone

(801) 601-1450

Specialties & licenses 1

Addresses

Other names 1

• Stockton Nursing Center Doing business as

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1447817739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 SHELLEY CT",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077232",
            "telephone_number": "801-601-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON NURSING AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "HIXSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "801-601-1450"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stockton Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Stockton, CA
• Providers in Stockton, 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 30, 2020; 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.