Organization Active NPI

SSC Weaverville Operating Company LLC

  • Skilled Nursing Facility
  • Weaverville, NC
National Provider Identifier
1629198577
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0532 Issued in NC
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

Updated by the provider on Nov 17, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3425221MedicaidNC
7805261MedicaidNC
3426255MedicaidNC

Other names 1

  • Brian Center Health & Rehabilitation - Weaverville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.