Ponderosa Care Communities a, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020413 Issued in CO

Legal business name

PONDEROSA CARE COMMUNITIES A, LLC

Doing business as

North Star Rehabilitation and Care Community

Practice address

3185 W Arkansas Ave
Denver, CO 80219-4004

Phone

(303) 922-1169

Fax

(303) 934-0220

NPI assigned

Feb 11, 2016

Organization subpart

No

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

Authorized official

Name

Mary Koretke

Title

Director of Reimbursement

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Star Rehabilitation and Care Community Doing business as

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1548629066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3185 W ARKANSAS AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194004",
            "telephone_number": "303-922-1169",
            "fax_number": "303-934-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 W ARKANSAS AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194004",
            "telephone_number": "303-922-1169",
            "fax_number": "303-934-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA CARE COMMUNITIES A, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16176367",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Rehabilitation and Care Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Nicholai Ponce, MD
• Olivia M Ponce, FMCP
• Melissa Poncy
• Nicole Lana Pond, PSYD
• Jessica Mary Ponder, FNP-BC
• Ponderosa Care Communities a, LLC (North Star Rehabilitation and Care Community)
• Ponderosa Natural Medicine LLC
• Ponderosa Vision Clinic, PC (Lowry EyeCare Specialists)
• Yekaterina Ponomareva, RN
• Sasha Michelle Pontejos

• Skilled Nursing Facility in Denver, CO
• Providers in Denver, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.

Verify at the official NPI Registry.