Ellenburg Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCF-231 Issued in SC

Legal business name

ELLENBURG NURSING CENTER, INC.

Practice address

611 E Hampton St
Anderson, SC 29624-2814

Phone

(864) 226-5054

Fax

(864) 226-5643

NPI assigned

Jun 8, 2006

Last updated

Apr 17, 2008By 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

Mr. Lyndon W Ellenburg

Title

Administrator

Phone

(864) 226-5054

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1871533588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E HAMPTON ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296242814",
            "telephone_number": "864-226-5054",
            "fax_number": "864-226-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E HAMPTON ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296242814",
            "telephone_number": "864-226-5054",
            "fax_number": "864-226-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLENBURG NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "ELLENBURG",
        "authorized_official_first_name": "LYNDON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "864-226-5054",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF-231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.