Sunbridge Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

24 Issued in ID

Legal business name

SUNBRIDGE HEALTHCARE LLC

Doing business as

Payette Center

Practice address

1019 3Rd Ave S
Payette, ID 83661-2832

Phone

(208) 642-4455

NPI assigned

May 27, 2006

Last updated

Mar 28, 2017By 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

Michael T Berg

Title

Assistant Secretary

Phone

(505) 468-4752

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Payette Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sunbridge Healthcare LLC

  dba Columbia Crest Center

  • Skilled Nursing Facility
  • Moses Lake, WA
  • NPI 1982651758

  Member Of

  NPD member

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1851348635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 3RD AVE S",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612832",
            "telephone_number": "208-642-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 3RD AVE S",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836612832",
            "telephone_number": "208-642-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "01156",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010013110",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8041298",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payette Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip E Stevenson, PA-C
• Marcia Strahn, CNM
• Anthony Leon Strasser, D.C.
• Bella Strasser, DC
• Alaina Leilokelani Stroebel, LPC
• Yvette Rene Sweet, DO
• Angela Kay Taylor, MS, LCPC
• Lindsey Lee Taylor, RDH
• Savannah Jo Taylor
• Robert Thompson Thayer

• Skilled Nursing Facility in Payette, ID
• Providers in Payette, ID by specialty
• Skilled Nursing Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.