NPIMap

Organization Active NPI

Guardian Health Care Provider Inc.

  • Skilled Nursing Facility
  • Brentwood, TN
National Provider Identifier
1891121992
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4042 Issued in NM
Legal business name
GUARDIAN HEALTH CARE PROVIDER INC.
Practice address
105 Westpark Dr Ste 100
Brentwood, TN 37027-5319
Phone
(800) 365-5787
NPI assigned
Sep 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Authorized official

Name
Ms. Genelyn Geronimo Acacio
Title
Physical Therapist
Phone
(347) 595-0692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4042 NM Primary

Addresses

Primary practice location

105 Westpark Dr Ste 100
Brentwood, TN 37027-5319

Mailing address

300 S Foch St
#3
Truth Or Consequences, NM 87901-3330
Phone (347) 595-0692

National Provider Directory

National Provider Directory
Tax ID family
Guardian Healthcare Providers Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1891121992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S FOCH ST",
            "address_2": "#3",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879013330",
            "telephone_number": "347-595-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WESTPARK DR STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275319",
            "telephone_number": "800-365-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN HEALTH CARE PROVIDER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "ACACIO",
        "authorized_official_first_name": "GENELYN",
        "authorized_official_middle_name": "GERONIMO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "347-595-0692",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NM",
            "license": "4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.