Chris Ridge Village Health Care Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-367 Issued in AZ

Legal business name

CHRIS RIDGE VILLAGE HEALTH CARE CENTER

Practice address

6246 N 19TH Ave
Phoenix, AZ 85015-1511

Phone

(602) 433-6300

Fax

(602) 433-5458

NPI assigned

Oct 12, 2005

Organization subpart

No

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

Authorized official

Name

Teresa Williamson

Title

Administrator

Phone

(602) 433-6300

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Chris Ridge Village2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• LB Phoenix Bethany Home Road LLC

  • Skilled Nursing Facility
  • Phoenix, AZ
  • NPI 1942355219
  NPD tax ID

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1649268657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6246 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151511",
            "telephone_number": "602-433-6300",
            "fax_number": "602-433-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6246 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151511",
            "telephone_number": "602-433-6300",
            "fax_number": "602-433-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS RIDGE VILLAGE HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-433-6300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355976",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Choy, M.D.
• CHP Care, PC
• Brooke Chramosta
• Chris J. Woolaver DDS MSC PC
• Chris Ridge Senior Living, LLC
• Chris Simopoulos LLC
• Christina Chrisman, M.D.
• Kimberly Jae Chrisman, PA-C
• Nicole Chrisman
• Cara Morgan Christ, MD

• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.