Active NPI
Advanced Health Care Corporation
- Skilled Nursing Facility
- Grangeville, ID
National Provider Identifier
1528099744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ADVANCED HEALTH CARE CORPORATION
- Practice address
- 410 E North 2ND St
Grangeville, ID 83530-2258 - Phone
- (208) 983-1131
- Fax
- (208) 983-9140
- NPI assigned
- Jul 5, 2006
- Organization subpart
- Yes
- Parent organization
- ADVANCED HEALTH CARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David W Nattress
- Title
- President
- Phone
- (801) 447-9860
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
410 E North 2ND St
Grangeville, ID 83530-2258
Mailing address
140 N Union Ave Ste 230
Farmington, UT 84025-2961
Phone (208) 739-1461
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805967300 | Medicaid | ID |
Other names 1
- Grangeville Health & Rehab
National Provider Directory
National Provider Directory- Part of
- Advanced Health Care Corporation
Locations
722 W North St
Grangeville, ID 83530
Phone (208) 983-8504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1626134400000",
"number": "1528099744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 N UNION AVE STE 230",
"city": "FARMINGTON",
"state": "UT",
"postal_code": "840252961",
"telephone_number": "208-739-1461",
"fax_number": "801-475-0419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E NORTH 2ND ST",
"city": "GRANGEVILLE",
"state": "ID",
"postal_code": "835302258",
"telephone_number": "208-983-1131",
"fax_number": "208-983-9140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED HEALTH CARE CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADVANCED HEALTH CARE CORPORATION",
"enumeration_date": "2006-07-05",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A",
"authorized_official_last_name": "NATTRESS",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "801-447-9860"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805967300",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grangeville Health & Rehab",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Grangeville Health & Rehab",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grangeville, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.