Organization Active NPI

SSC Englewood Operating Company LLC

  • Respite Care
  • Englewood, CO
National Provider Identifier
1629565270
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
0011 Issued in CO
Legal business name
SSC ENGLEWOOD OPERATING COMPANY LLC
Doing business as
Pearl Street Health & Rehabilitation Center
Practice address
3636 S Pearl St
Englewood, CO 80113-3806
Phone
(303) 761-1640
NPI assigned
Apr 19, 2018
Organization subpart
Yes
Parent organization
SSC ENGLEWOOD OPERATING COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Authorized official

Name
Ken Pitts
Title
Director Reimbursement
Phone
(832) 467-6793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 0011 CO Primary

Addresses

Primary practice location

3636 S Pearl St
Englewood, CO 80113-3806

Mailing address

5300 W Sam Houston Pkwy N Ste 100
Houston, TX 77041-5162
Phone (832) 467-6000

Other identifiers 1

IdentifierTypeStateIssuer
9000160003MedicaidCO

Other names 1

  • Pearl Street Health & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
SSC Englewood Operating Company LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1629565270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415162",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 S PEARL ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133806",
            "telephone_number": "303-761-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC ENGLEWOOD OPERATING COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSC ENGLEWOOD OPERATING COMPANY LLC",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "832-467-6793"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CO",
            "license": "0011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000160003",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearl Street Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearl Street Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.