SSC Fort Collins Lemay Avenue Operating Company LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

License

1291 Issued in CO

Legal business name

SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC

Doing business as

Fort Collins Health Care Center

Practice address

1000 S Lemay Ave
Fort Collins, CO 80524-3914

Phone

(970) 482-7925

Fax

(970) 493-1686

NPI assigned

Apr 9, 2018

Organization subpart

Yes

Parent organization

SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Ken Pitts

Title

Director Reimbursement

Phone

(832) 467-6793

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fort Collins Health Care Center Doing business as

Part of

SSC Fort Collins Lemay Avenue Operating Company LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• SSC Fort Collins Lemay Avenue Operating Company LLC

  dba Fort Collins Health Care Center

  • Skilled Nursing Facility
  • Fort Collins, CO
  • NPI 1699895557
  NPPES parent name

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1538666359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415162",
            "telephone_number": "832-467-6000",
            "fax_number": "832-467-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243914",
            "telephone_number": "970-482-7925",
            "fax_number": "970-493-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "832-467-6793"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "1291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000159189",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Collins Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary Jan Spruill, DDS
• Kimberly Joy Spurlock, M.A.,CCC-SLP
• Kyle Spurlock
• Kimberly Spurny, RBT
• Square One Health LLC
• SSC Fort Collins Lemay Avenue Operating Company LLC (Fort Collins Health Care Center)
• SSC Fort Collins Spring Creek Operating Company LLC (Spring Creek Healthcare Center)
• SSC Fort Collins Spring Creek Operating Company LLC (Garden Square at Spring Creek)
• St Lukes Medical Clinic LLC
• Matthew Stachniak

• Respite Care in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Respite Care in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.