SNH Neb Tenant LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SNH NEB TENANT LLC

Practice address

510 Centennial Cir
North Platte, NE 69101-6586

Phone

(308) 534-7000

Fax

(308) 534-8216

NPI assigned

Aug 22, 2019

Organization subpart

Yes

Parent organization

SNH NEB TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Centennial Park Retirement Village Doing business as

Part of

SNH Neb Tenant LLC

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1609423706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CENTENNIAL CIR",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016586",
            "telephone_number": "308-534-7000",
            "fax_number": "308-534-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH NEB TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH NEB TENANT LLC",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Park Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Ann Smith, PLMHP
• Shirleen Smith
• Sue Ann Smith
• Tarik Smith, PHARMD
• Tyrel Smith
• William Snodgrass, RP
• Kathryn Emma Snoozy, CRNA
• Leah Snyder
• Kaylene Sodawasser
• Chea Sok, MD

• Skilled Nursing Facility in North Platte, NE
• Providers in North Platte, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.