Shore Lifecare, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH2475 Issued in VA

Legal business name

SHORE LIFECARE, INC.

Practice address

26181 Parksley Rd
Parksley, VA 23421-3723

Phone

(757) 665-5133

Fax

(757) 665-5136

NPI assigned

May 11, 2006

Last updated

Jan 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Walter William Austin Jr.

Title

Sr VP/Cfo/Treasurer

Phone

(757) 531-7015

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Riverside Shore Rehabilitation Center Other name

Tax ID family

Riverside Shore Rehabilitation Center2 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.

• Shore Healthcare Group, LLC

  dba Shore Health & Rehab Center

  • Skilled Nursing Facility
  • Parksley, VA
  • NPI 1235646738
  NPD tax ID

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1669422853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BLVD STE 600",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084411",
            "telephone_number": "757-875-2023",
            "fax_number": "757-875-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26181 PARKSLEY RD",
            "city": "PARKSLEY",
            "state": "VA",
            "postal_code": "234213723",
            "telephone_number": "757-665-5133",
            "fax_number": "757-665-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE LIFECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "SR VP/CFO/TREASURER",
        "authorized_official_telephone_number": "757-531-7015",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "VA",
            "license": "NH2475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MED EQUIPMENT",
            "identifier": "1273950001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004953347",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Shore Rehabilitation Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Riverside Shore Rehabilitation Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alicia Nicole Rose, CNS, NP
• Runningers Pharmacy Inc
• Maudene Sherman, LCSW
• Shore Health Services, Inc (Riverside Shore Medical Center at Metompkin)
• Shore Healthcare Group, LLC (Shore Health & Rehab Center)
• Shore Transport Services Inc.
• Ebony Lea'Shay Smith, LCSW
• Deborah K. Van Den Berg, GNP
• Debra Jeanne Wharton, LPC
• Shenay Wharton, LPC,LSATP

• Nursing Facility/Intermediate Care Facility in Parksley, VA
• Providers in Parksley, VA by specialty
• Nursing Facility/Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.