Active NPI
SSC Weaverville Operating Company LLC
- Skilled Nursing Facility
- Weaverville, NC
National Provider Identifier
1629198577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH0532
- Legal business name
- SSC WEAVERVILLE OPERATING COMPANY LLC
- Practice address
- 78 Weaver Blvd
Weaverville, NC 28787-9322 - Phone
- (828) 645-4297
- NPI assigned
- Mar 31, 2007
- Organization subpart
- No
NPPES NPI Registry
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | NH0532 | NC | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH0532 | NC | |
| Skilled Nursing Facility | 314000000X | NH0532 | NC | Primary |
Addresses
Primary practice location
78 Weaver Blvd
Weaverville, NC 28787-9322
Mailing address
5300 W Sam Houston Pkwy N
Suite 100
Houston, TX 77041-5161
Phone (770) 829-5100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3425221 | Medicaid | NC | |
| 7805261 | Medicaid | NC | |
| 3426255 | Medicaid | NC |
Other names 1
- Brian Center Health & Rehabilitation - Weaverville
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1605571200000",
"number": "1629198577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 W SAM HOUSTON PKWY N",
"address_2": "SUITE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770415161",
"telephone_number": "770-829-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 WEAVER BLVD",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "287879322",
"telephone_number": "828-645-4297"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SSC WEAVERVILLE OPERATING COMPANY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-31",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"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": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": "NC",
"license": "NH0532",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NC",
"license": "NH0532",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "NH0532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3425221",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7805261",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3426255",
"state": "NC"
}
],
"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": "Brian Center Health & Rehabilitation - Weaverville",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Brian Center Health & Rehabilitation - Weaverville",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Weaverville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.