Active NPI
Country Hills Health Care Incorporated
- Skilled Nursing Facility
- El Cajon, CA
National Provider Identifier
1700973963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 08000361
- Legal business name
- COUNTRY HILLS HEALTH CARE INCORPORATED
- Practice address
- 1580 Broadway
El Cajon, CA 92021-5124 - Phone
- (619) 441-8745
- Fax
- (619) 334-3248
- NPI assigned
- Oct 9, 2006
- Last updated
- Dec 20, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Carol J Patten
- Title
- Accounts Receivable Supervisor
- Phone
- (619) 441-8745
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 08000361 | CA | Primary |
| Nursing Facility Supplies (DME) | 332BN1400X | CA | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | CA |
Addresses
Primary practice location
1580 Broadway
El Cajon, CA 92021-5124
Mailing address
1580 Broadway
El Cajon, CA 92021-5124
Phone (619) 441-8745
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CMCSUB0TC | Other | CA | MEDICAL INTERNET USER ID |
| LTC55431G | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387497600000",
"number": "1700973963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1580 BROADWAY",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920215124",
"telephone_number": "619-441-8745",
"fax_number": "619-334-3248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 BROADWAY",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920215124",
"telephone_number": "619-441-8745",
"fax_number": "619-334-3248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTRY HILLS HEALTH CARE INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-09",
"last_updated": "2013-12-20",
"status": "A",
"authorized_official_last_name": "PATTEN",
"authorized_official_first_name": "CAROL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "ACCOUNTS RECEIVABLE SUPERVISOR",
"authorized_official_telephone_number": "619-441-8745",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "08000361",
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL INTERNET USER ID",
"identifier": "CMCSUB0TC",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55431G",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.