Active NPI
Sunbridge Healthcare LLC
- Skilled Nursing Facility
- Lawrence, MA
National Provider Identifier
1528019510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0249
- Legal business name
- SUNBRIDGE HEALTHCARE LLC
- Doing business as
- Colonial Heights
- Practice address
- 555 S Union St
Lawrence, MA 01843-2815 - Phone
- (978) 682-5281
- Fax
- (978) 682-0286
- NPI assigned
- May 13, 2006
- Organization subpart
- Yes
- Parent organization
- SUN HEALTHCARE GROUP, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas Divittorio
- Title
- Sr. VP and Cfo
- Phone
- (610) 444-6350
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0249 | MA | |
| Skilled Nursing Facility | 314000000X | 0249 | MA | Primary |
Addresses
Primary practice location
555 S Union St
Lawrence, MA 01843-2815
Mailing address
101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-4742
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0927805 | Medicaid | MA |
Other names 1
- Colonial Heights
National Provider Directory
National Provider Directory- Part of
- Sun Healthcare Group
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": "1147478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1471996800000",
"number": "1528019510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SUN AVE NE",
"address_2": "COMPLIANCE DEPARTMENT",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094373",
"telephone_number": "505-468-4742",
"fax_number": "505-468-8742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 S UNION ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018432815",
"telephone_number": "978-682-5281",
"fax_number": "978-682-0286"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNBRIDGE HEALTHCARE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUN HEALTHCARE GROUP, INC.",
"enumeration_date": "2006-05-13",
"last_updated": "2016-08-24",
"status": "A",
"authorized_official_last_name": "DIVITTORIO",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "SR. VP AND CFO",
"authorized_official_telephone_number": "610-444-6350"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "MA",
"license": "0249",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "0249",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0927805",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Colonial Heights",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.