Salem Nursing and Rehabilitation of Tuskegee

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12605 Issued in AL

Legal business name

SALEM NURSING AND REHABILITATION OF TUSKEGEE

Practice address

502 Gautier St
Tuskegee, AL 36083-2600

Phone

(334) 727-1945

Fax

(334) 727-3438

NPI assigned

Jul 9, 2006

Last updated

Mar 4, 2008By 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

Douglas K Mittleider

Title

President

Phone

(770) 619-0866

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1528091709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 GAUTIER ST",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360832600",
            "telephone_number": "334-727-1945",
            "fax_number": "334-727-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 GAUTIER ST",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360832600",
            "telephone_number": "334-727-1945",
            "fax_number": "334-727-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM NURSING AND REHABILITATION OF TUSKEGEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "MITTLEIDER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-619-0866"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757110S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline M. Ross, LMSW
• Lakisha Wennell Ross, DENTAL HYGIENIST
• Lisa Roten
• Nirmala Jasti Rozario, M.D.,PH.D
• Jennifer R. Rutledge, LGSW
• Stephen Arnold Sams, PHD
• Whitney Scifres, MD
• Edra Lynette Scott, LISW
• Jorie G Scott, SOCIAL WORKER
• Marvia S Scott, LICSW

• Skilled Nursing Facility in Tuskegee, AL
• Providers in Tuskegee, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.