NPIMap

Organization Active NPI

Scallop Shell Nursing & Rehabilitation Center, Inc.

  • Skilled Nursing Facility
  • Peace Dale, RI
National Provider Identifier
1811999576
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
LTC00352 Issued in RI
Legal business name
SCALLOP SHELL NURSING & REHABILITATION CENTER, INC.
Practice address
981 Kingstown Rd
Peace Dale, RI 02879-3042
Phone
(401) 789-3006
Fax
(401) 789-3562
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Neil E. Mahoney
Title
Administrator
Phone
(401) 789-3006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X LTC00352 RI Primary

Addresses

Primary practice location

981 Kingstown Rd
Peace Dale, RI 02879-3042

Mailing address

981 Kingstown Rd
Peace Dale, RI 02879-3042
Phone (401) 789-3006

Other identifiers 1

IdentifierTypeStateIssuer
4105057MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
981 Kings Town Road Operating Company LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811999576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 KINGSTOWN RD",
            "city": "PEACE DALE",
            "state": "RI",
            "postal_code": "028793042",
            "telephone_number": "401-789-3006",
            "fax_number": "401-789-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 KINGSTOWN RD",
            "city": "PEACE DALE",
            "state": "RI",
            "postal_code": "028793042",
            "telephone_number": "401-789-3006",
            "fax_number": "401-789-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCALLOP SHELL NURSING & REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-789-3006"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "LTC00352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105057",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peace Dale, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.