SSC Mount Vernon Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1733907 Issued in IL

Legal business name

SSC MOUNT VERNON OPERATING COMPANY LLC

Practice address

1001 S 34TH St
Mount Vernon, IL 62864-6232

Phone

(618) 242-5700

NPI assigned

Apr 2, 2007

Organization subpart

No

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

• Nature Trail Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 16, 2020.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1689795379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S 34TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646232",
            "telephone_number": "618-242-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC MOUNT VERNON OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1733907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDR eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nature Trail Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nature Trail Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Mount Vernon, IL
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.