Country Care Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N052002 Issued in KS

Legal business name

COUNTRY CARE INC.

Practice address

515 Dawson St
Easton, KS 66020-9200

Phone

(913) 773-5517

Fax

(913) 773-5562

NPI assigned

Nov 18, 2005

Last updated

Jan 18, 2012By 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

Mrs. Tamara Kelly O'Donnell, BSN, RN, MBA, ADMIN

Title

President, Country Care, Inc

Phone

(913) 773-5517

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1831171453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 DAWSON ST",
            "city": "EASTON",
            "state": "KS",
            "postal_code": "660209200",
            "telephone_number": "913-773-5517",
            "fax_number": "913-773-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 DAWSON ST",
            "city": "EASTON",
            "state": "KS",
            "postal_code": "660209200",
            "telephone_number": "913-773-5517",
            "fax_number": "913-773-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT, COUNTRY CARE, INC",
        "authorized_official_telephone_number": "913-773-5517",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN, MBA, ADMIN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "N052002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100109970A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anew Healthcare Operations - Easton, LLC (Anew Healthcare Easton)
• Ccic LLC (Country Care on Broadway)
• Blaine Domann, PTA
• Easton Health Care Center, L.L.C. (Easton Health Care Center)
• Easton SNF Opco LLC (Easton Health Care Center)
• Easton Usd 449
• John Robert Glaves

• Skilled Nursing Facility in Easton, KS
• Providers in Easton, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.