Sunshine Manor, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

037234 Issued in MO

Legal business name

SUNSHINE MANOR, LLC

Practice address

894 Leland Ave
University City, MO 63130-3239

Phone

(314) 726-4767

Fax

(314) 726-1308

NPI assigned

Sep 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Sharo Shirshekan

Title

Managing Member

Phone

(573) 701-0600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1659368124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 LELAND AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303239",
            "telephone_number": "314-726-4767",
            "fax_number": "314-726-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 LELAND AVE",
            "city": "UNIVERSITY CITY",
            "state": "MO",
            "postal_code": "631303239",
            "telephone_number": "314-726-4767",
            "fax_number": "314-726-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "SHIRSHEKAN",
        "authorized_official_first_name": "SHARO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "573-701-0600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "037234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101485308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in University City, MO
• Providers in University City, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.