South Capitol Cottage Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

SOUTH CAPITOL COTTAGE INC

Practice address

15054 Daisy Rd
Adelanto, CA 92301-4824

Phone

(951) 662-3026

NPI assigned

Jan 21, 2007

Last updated

Sep 1, 2015By 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

Miss Carol Frazier, LVNNPI 1659605376

Title

President

Phone

(951) 662-3026

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carol Frazier, LVN

  • Licensed Vocational Nurse
  • Colton, CA
  • NPI 1659605376
  NPD (past) Authorized official

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1912050956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 DE CARMEN DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246248",
            "telephone_number": "951-662-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15054 DAISY RD",
            "city": "ADELANTO",
            "state": "CA",
            "postal_code": "923014824",
            "telephone_number": "951-662-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAPITOL COTTAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-21",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-662-3026",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6310014738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Sepulveda
• Angelica Maria Serrano
• Paul William Shafer
• Shaw Pearson Transport LLC
• Luis Soto Jr.
• St. Jude Neighborhood Health Centers
• Vannak Taing
• Oliver Jaldo Tanguilan
• Susan Tanner, APRN
• The Universal of Science and Peace

• Nursing Facility/Intermediate Care Facility in Adelanto, CA
• Providers in Adelanto, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.