Woodland Nursing Inn, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WOODLAND NURSING INN, INC.

Practice address

3721 Mt Diablo Blvd
Lafayette, CA 94549-3538

Phone

(925) 284-5544

Fax

(925) 284-5673

NPI assigned

Aug 16, 2005

Organization subpart

No

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

Authorized official

Name

Jeremy E Grimes

Title

President

Phone

(925) 855-0881

Specialties & licenses 4

Addresses

Other identifiers 2

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1629060702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CROW CANYON CT",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831966",
            "telephone_number": "925-855-0881",
            "fax_number": "925-855-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 MT DIABLO BLVD",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493538",
            "telephone_number": "925-284-5544",
            "fax_number": "925-284-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND NURSING INN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-855-0881"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC NUMBER",
            "identifier": "1128360001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC 06469G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.