NPIMap

Organization Active NPI

Silver Oak Senior Living Management, LC

  • Assisted Living Facility
  • Nevada, MO
National Provider Identifier
1720105786
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
3032548 Issued in MO
Legal business name
SILVER OAK SENIOR LIVING MANAGEMENT, LC
Practice address
1505 E Ashland St
Nevada, MO 64772-4025
Phone
(417) 667-3900
Fax
(417) 667-3923
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Authorized official

Name
Sam Crosby
Title
Owner
Phone
(417) 667-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 3032548 MO Primary

Addresses

Primary practice location

1505 E Ashland St
Nevada, MO 64772-4025

Mailing address

1505 E Ashland St
Nevada, MO 64772-4025
Phone (417) 667-3900

Other identifiers 1

IdentifierTypeStateIssuer
264878109MedicaidMO

Other names 1

  • Silver Oak Senior Living at Nevada II Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Silver Oak Senior Living at Butler4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1505 E Ashland St
Nevada, MO 64772
Phone (417) 667-3900

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1720105786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E ASHLAND ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647724025",
            "telephone_number": "417-667-3900",
            "fax_number": "417-667-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E ASHLAND ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647724025",
            "telephone_number": "417-667-3900",
            "fax_number": "417-667-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER OAK SENIOR LIVING MANAGEMENT, LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-667-3900"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "3032548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264878109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Oak Senior Living at Nevada II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nevada, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.