Manor Care of Walnut Creek Ca LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

140000368 Issued in CA

Legal business name

MANOR CARE OF WALNUT CREEK CA LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Rossmoor)

Practice address

1226 Rossmoor Pkwy
Walnut Creek, CA 94595-2538

Phone

(925) 975-5000

Fax

(925) 937-1132

NPI assigned

May 30, 2006

Last updated

Feb 11, 2022By 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. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Rossmoor) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1720035090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952538",
            "telephone_number": "925-975-5000",
            "fax_number": "925-937-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF WALNUT CREEK CA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "140000368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720035090",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Rossmoor)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Rossmoor)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hibah Jawed Maniar
• Alexandra Jean A. Maniego
• Manisha Manmohan, M.D.
• Marissa Mannina, PHD, LP
• Kathleen Manning, MD
• Manor Care Tice Valley Ca LLC (ProMedica Skilled Nursing and Rehabilitation (Tice Valley))
• Colin Mansfield, M.D.
• Grant Roberts Manson
• Maria Allyson Manuel, M.A./BCBA
• Sheenarose Manuel

• Skilled Nursing Facility in Walnut Creek, CA
• Providers in Walnut Creek, 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 Feb 11, 2022; 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.