SSC Greenfield Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3177 Issued in WI

Legal business name

SSC GREENFIELD OPERATING COMPANY LLC

Practice address

4500 W Loomis Rd
Greenfield, WI 53220-4819

Phone

(414) 325-5300

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Thomas P. Simons

Title

Senior VP Operations Finance

Phone

(770) 829-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southpointe Healthcare Center Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1629199047",
    "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": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W LOOMIS RD",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204819",
            "telephone_number": "414-325-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC GREENFIELD OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "SENIOR VP OPERATIONS FINANCE",
        "authorized_official_telephone_number": "770-829-5100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20194400",
            "state": "WI"
        }
    ],
    "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": "Southpointe Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southpointe Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leslie Wahl Spencer, DPT
• Steven M Sperry, MD
• Sue E Spivey, L.P.N.
• Gerald F Splittgerber, MD
• Sports Medicine & Orthopedic Center, S.C.
• Constantine Stamatelakys, DDS
• Stans Bootery Inc
• Rick Staral, PHARMD
• Patricia Ann Stark, LPN
• Sharon Louise Cello Starks, PTA

• All providers in Greenfield, WI
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.