Sole Proprieter

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10990 Issued in FL

Legal business name

SOLE PROPRIETER

Practice address

526 Portrush LN
Cibolo, TX 78108-4340

Phone

(210) 748-2945

NPI assigned

Dec 28, 2010

Organization subpart

No

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

Authorized official

Name

Stephanie Rae Redding

Title

Cota

Phone

(210) 748-2945

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1881998391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 PORTRUSH LN",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "78108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 PORTRUSH LN",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781084340",
            "telephone_number": "210-748-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLE PROPRIETER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "REDDING",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "210-748-2945"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AL",
            "license": "3040",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "10990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Arthur Small, PA-C
• Jessica Marie Smarro, LCSW
• Smith Primary Home Care LLC
• Margaret Lynn Smith
• Tammy Lee Smith
• Cassandra Lisette Sosa, LPC
• Trina Denise St Ann, PA-C
• Bridgett Sterling, DNP, MSN, MHA, RN
• Ladestanie Sterling
• Jessica R Stoffel, PT, DPT

• Skilled Nursing Facility in Cibolo, TX
• Providers in Cibolo, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.