Clarkston Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLARKSTON OPERATING COMPANY LLC

Doing business as

Clarkston Specialty Healthcare Center

Practice address

4800 Clintonville Rd
Clarkston, MI 48346-4297

Phone

(248) 674-0903

NPI assigned

Nov 5, 2013

Last updated

Nov 11, 2020By 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

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other names 1

• Clarkston Specialty Healthcare Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1548699036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 CLINTONVILLE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464297",
            "telephone_number": "248-674-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CLINTONVILLE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464297",
            "telephone_number": "248-674-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDR eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clarkston Specialty Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarkston Specialty Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Clarkston, MI
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• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.