N & R of Portageville, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030678 Issued in MO

Legal business name

N & R OF PORTAGEVILLE, INC.

Doing business as

Portageville Nursing Center

Practice address

290 W State Highway 162
Portageville, MO 63873-9397

Phone

(573) 379-2017

Fax

(573) 379-2735

NPI assigned

Sep 22, 2005

Last updated

Jan 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Hudspeth

Title

Coo Cfo

Phone

(573) 392-0316

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Portageville Nursing Center Doing business as

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1487640777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 408",
            "city": "PORTAGEVILLE",
            "state": "MO",
            "postal_code": "638730408",
            "telephone_number": "573-379-2017",
            "fax_number": "573-379-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 W STATE HIGHWAY 162",
            "city": "PORTAGEVILLE",
            "state": "MO",
            "postal_code": "638739397",
            "telephone_number": "573-379-2017",
            "fax_number": "573-379-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF PORTAGEVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "HUDSPETH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "COO CFO",
        "authorized_official_telephone_number": "573-392-0316",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103235008",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "16877926",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portageville Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mid-South Service Group, Inc.
• Jaelyn Alexis Milam, PTA
• Missouri Bootheel Regional Consortium, Inc.
• Missouri Delta Medical Center (Portageville Community Care Center)
• David W Morris
• Pemiscot County Memorial Hospital (Portageville Primary Care Center)
• Portageville Health Care Center, L.L.C. (Portageville Health Care Center)
• Portageville Nursing and Rehabilitation, LLC
• Portageville School District
• Portageville SNF Opco LLC (Portageville Health Care Center)

• Skilled Nursing Facility in Portageville, MO
• Providers in Portageville, 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 21, 2009; 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.