NPIMap

Organization Active NPI

St. Johnland Nursing Center , Inc.

  • Adult Day Care Clinic/Center
  • Kings Park, NY
National Provider Identifier
1518037837
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
5157311N Issued in NY
Legal business name
ST. JOHNLAND NURSING CENTER , INC.
Practice address
395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone
(631) 269-5800
Fax
(631) 269-5876
NPI assigned
Nov 8, 2006
Last updated
Nov 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Mrs. Mary Jean Weber, LNHA
Title
Ceo - Administrator
Phone
(631) 269-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 5157311N NY Primary

Addresses

Primary practice location

395 Sunken Meadow Rd
Kings Park, NY 11754-1000

Mailing address

395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone (631) 269-5800

Other identifiers 1

IdentifierTypeStateIssuer
01064337MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
St Johnland Nursing Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1518037837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNLAND NURSING CENTER , INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO - ADMINISTRATOR",
        "authorized_official_telephone_number": "631-269-5800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NY",
            "license": "5157311N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01064337",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.