Shadowbrook Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHADOWBROOK POST ACUTE LLC

Doing business as

Shadowbrook Post Acute

Practice address

1 Gilmore LN
Oroville, CA 95966-5147

Phone

(530) 534-1353

NPI assigned

Jan 29, 2016

Last updated

Jan 29, 2016By 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

David Johnson

Title

Ceo

Phone

(888) 309-0022

Specialties & licenses 1

Addresses

Other names 1

• Shadowbrook Post Acute Doing business as

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1750749172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N PUENTE ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GILMORE LN",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959665147",
            "telephone_number": "530-534-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOWBROOK POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-309-0022"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadowbrook Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Jean Serpa, RDH
• Vianey Jaimar Serrano
• Carlo F Serusa Jr., RPH
• Supriya Sethi
• Shadowbrook Health Care, Inc. (Shadowbrook Health Care)
• Ravi Yatin Shah, PHARMD
• Unnati Shah, MD
• Roy Carl Shannon, MD
• Preeti Shenoy
• Paula Lee Shetrone

• Skilled Nursing Facility in Oroville, CA
• Providers in Oroville, 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 Jan 29, 2016; 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.