NPIMap

Organization Active NPI

St. Johnland Nursing Center, Inc.

  • Home Health Agency
  • Kings Park, NY
National Provider Identifier
1609946920
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5157902L Issued in NY
Legal business name
ST. JOHNLAND NURSING CENTER, INC.
Practice address
395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone
(631) 269-5800
Fax
(631) 269-5876
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Authorized official

Name
Mrs. Mary Jean Weber, LNHA
Title
Ceo - Administrator
Phone
(631) 269-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5157902L NY Primary

Addresses

Primary practice location

395 Sunken Meadow Rd
Kings Park, NY 11754-1000

Mailing address

395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone (631) 269-5800

Other identifiers 1

IdentifierTypeStateIssuer
01291029MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1609946920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-269-5800",
            "fax_number": "631-269-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNLAND NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO - ADMINISTRATOR",
        "authorized_official_telephone_number": "631-269-5800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "5157902L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01291029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.