Shadowbrook Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

230000059 Issued in CA

Legal business name

SHADOWBROOK HEALTH CARE, INC.

Doing business as

Shadowbrook Health Care

Practice address

1 Gilmore LN
Oroville, CA 95966-5147

Phone

(530) 534-1353

Fax

(530) 534-0632

NPI assigned

Aug 3, 2005

Last updated

Nov 20, 2013By 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

Mr. Terry Bane

Title

President

Phone

(530) 897-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shadowbrook Health Care Doing business as

Locations

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1669473310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GILMORE LN",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665147",
            "telephone_number": "530-534-1353",
            "fax_number": "530-534-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GILMORE LN",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665147",
            "telephone_number": "530-534-1353",
            "fax_number": "530-534-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOWBROOK HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "BANE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-897-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05612I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadowbrook Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serenity Haven Hospice Care Inc
• Stephanie Jean Serpa, RDH
• Vianey Jaimar Serrano
• Carlo F Serusa Jr., RPH
• Supriya Sethi
• Shadowbrook Post Acute LLC (Shadowbrook Post Acute)
• Ravi Yatin Shah, PHARMD
• Unnati Shah, MD
• Roy Carl Shannon, MD
• Preeti Shenoy

• Skilled Nursing Facility in Oroville, CA
• Providers in Oroville, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.