Ggnsc Erie Western Reserve LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

490802 Issued in PA

Legal business name

GGNSC ERIE WESTERN RESERVE LP

Practice address

1521 W 54TH St
Erie, PA 16509-2620

Phone

(814) 864-0671

Fax

(814) 866-5681

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Holly A. Rasmussen-Jones

Title

Sec. of the GP

Phone

(479) 201-4835

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Golden LivingCenter - Western Reserve Doing business as

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1891746178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 W 54TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092620",
            "telephone_number": "814-864-0671",
            "fax_number": "814-866-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 W 54TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092620",
            "telephone_number": "814-864-0671",
            "fax_number": "814-866-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GGNSC ERIE WESTERN RESERVE LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "RASMUSSEN-JONES",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SEC. OF THE GP",
        "authorized_official_telephone_number": "479-201-4835"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "490802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK WESTERN PA",
            "identifier": "0656",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ION HEALTH",
            "identifier": "1007774460023",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015518640001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "318038",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101551864",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1505090",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS HEALTH PLAN",
            "identifier": "000000079448",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00745097",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "84012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden LivingCenter - Western Reserve",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Justin Germain, M.D.
• David J German, MD
• Jennifer Lynn Gervase, MSN, APRN, FNP-C
• Katherine Getty, CRNP
• Ggnsc Erie II LP
• Mindy Ghaemaghamy-Harris, LSW
• Maged Mahmoud Ghanem, MD
• Romeo Ghano
• Elaine Ghazinour
• Pratiti Ghosh Dastidar, MD

• Skilled Nursing Facility in Erie, PA
• Providers in Erie, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.