Canon City Nursing and Rehab Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CANON CITY NURSING AND REHAB CENTER, LLC

Practice address

515 Fairview Ave
Canon City, CO 81212-2863

Phone

(801) 601-1450

NPI assigned

Oct 16, 2019

Organization subpart

No

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

Authorized official

Name

Brooke Hixson

Title

Controller

Phone

(801) 941-3495

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1861034209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063069",
            "telephone_number": "801-601-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRVIEW AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122863",
            "telephone_number": "801-601-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANON CITY NURSING AND REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "HIXSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "801-941-3495"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Canon City, CO
• Providers in Canon City, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.