South Portland Nursing Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

36127 Issued in ME

Legal business name

SOUTH PORTLAND NURSING HOME, INC

Practice address

42 Anthoine St
South Portland, ME 04106-4403

Phone

(207) 799-8561

Fax

(207) 767-7401

NPI assigned

Jun 2, 2005

Organization subpart

No

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

Authorized official

Name

Cindy N Scott

Title

Administrator

Phone

(207) 799-8561

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1679575773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 ANTHOINE ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064403",
            "telephone_number": "207-799-8561",
            "fax_number": "207-767-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 ANTHOINE ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064403",
            "telephone_number": "207-799-8561",
            "fax_number": "207-767-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PORTLAND NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-799-8561"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "36127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.