NPIMap

Organization Active NPI

Charles County Nursing Home Inc

  • Skilled Nursing Facility
  • La Plata, MD
National Provider Identifier
1740261692
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
08003 Issued in MD
Legal business name
CHARLES COUNTY NURSING HOME INC
Practice address
10200 Laplata Rd
La Plata, MD 20646-3245
Phone
(301) 934-1900
Fax
(301) 539-7310
NPI assigned
Nov 8, 2005
Last updated
Jan 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Mr. William M Holman Jr.
Title
Chief Financial Officer
Phone
(301) 934-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 08003 MD Primary

Addresses

Primary practice location

10200 Laplata Rd
La Plata, MD 20646-3245

Mailing address

10200 Laplata Rd
La Plata, MD 20646-3245
Phone (301) 934-1900

Other identifiers 4

IdentifierTypeStateIssuer
502424200OtherMDADC-BR
472943900OtherMDADC-LAP
087007200MedicaidMD
024870300OtherMED B

Other names 1

  • Charles County Nursing & Rehab Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1740261692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 LAPLATA RD",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206463245",
            "telephone_number": "301-934-1900",
            "fax_number": "301-539-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 LAPLATA RD",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206463245",
            "telephone_number": "301-934-1900",
            "fax_number": "301-539-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES COUNTY NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-934-1900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "08003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADC-BR",
            "identifier": "502424200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADC-LAP",
            "identifier": "472943900",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087007200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED B",
            "identifier": "024870300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles County Nursing & Rehab Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.