NPIMap

Organization Active NPI

Sunbridge Clipper Home of North Conway LLC

Doing business as Mineral Springs

  • Skilled Nursing Facility
  • North Conway, NH
National Provider Identifier
1861448466
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
02454 Issued in NH
Legal business name
SUNBRIDGE CLIPPER HOME OF NORTH CONWAY LLC
Doing business as
Mineral Springs
Practice address
1251 White Mountain Hwy
North Conway, NH 03860-5154
Phone
(603) 356-7294
Fax
(603) 356-3316
NPI assigned
May 25, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 02454 NH
Nursing Facility/Intermediate Care Facility 313M00000X 02454 NH
Skilled Nursing Facility 314000000X 02454 NH Primary

Addresses

Primary practice location

1251 White Mountain Hwy
North Conway, NH 03860-5154

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 1

IdentifierTypeStateIssuer
30002362MedicaidNH

Other names 1

  • Mineral Springs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sunrise HLTH Care Corp28 organizations share this tax ID, including this one
Part of
Sunrise HLTH Care Corp

Other organizations with this tax ID 27

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

View all 27

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1861448466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038605154",
            "telephone_number": "603-356-7294",
            "fax_number": "603-356-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBRIDGE CLIPPER HOME OF NORTH CONWAY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE LLC",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-08-17",
        "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": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NH",
            "license": "02454",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NH",
            "license": "02454",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NH",
            "license": "02454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30002362",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mineral Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.