Hillcrest Shadow Lake LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HILLCREST SHADOW LAKE LLC

Practice address

1507 E Gold Coast Rd
Papillion, NE 68046-4722

Phone

(402) 682-4800

NPI assigned

May 6, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Jolene Roberts

Title

Ceo/President

Phone

(402) 682-4800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1871949024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 HARLAN DR",
            "address_2": "SUITE A",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680056609",
            "telephone_number": "402-682-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 E GOLD COAST RD",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464722",
            "telephone_number": "402-682-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST SHADOW LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JOLENE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "402-682-4800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026587800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Hill
• Chelsea Hill
• Elizabeth Anne Hill
• Shi'Randi A Hill
• Hillcrest Development Company LLC
• Hillcrest Shadow Lake, LLC
• Sophia Hiller
• Micala Hinkle
• Alyssa Ann Hinze
• Karly Hippe

• Skilled Nursing Facility in Papillion, NE
• Providers in Papillion, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.