SSC Lincolnton Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0385 Issued in NC

Legal business name

SSC LINCOLNTON OPERATING COMPANY LLC

Practice address

515 South Generals Blvd.
Lincolnton, NC 28092-3562

Phone

(704) 735-8065

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Brian Center Health and Retirement - Lincolnton Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1740301050",
    "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": "515 SOUTH GENERALS BLVD.",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923562",
            "telephone_number": "704-735-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC LINCOLNTON OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "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": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NC",
            "license": "NH0385",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "NH0385",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "NH0385",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425250",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805258",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3426351",
            "state": "NC"
        }
    ],
    "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": "Brian Center Health and Retirement - Lincolnton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brian Center Health and Retirement - Lincolnton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Staci Krisann Spake, FNP-C
• Speech Span
• Larissa Larke Spell-Berger, MSW
• Teneil Spivey
• Mary Splain, NP
• Amanda Steeb
• Elizabeth Dunn Stephens, LCSW
• Donald Kent Stewart IV, MD
• Robert Marion Stone III, DPT
• Jeremy Summey, PHARMD

• Skilled Nursing Facility in Lincolnton, NC
• Providers in Lincolnton, NC by specialty
• Skilled Nursing Facility in North Carolina

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.