FMG Alexander Street Washington LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG ALEXANDER STREET WASHINGTON LLC

Doing business as

Riverside Nursing and Rehabilitation Center

Practice address

1305 Alexander St
Centralia, WA 98531-1305

Phone

(360) 736-2823

Fax

(360) 736-1821

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

David C. Keating

Title

Agent

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Riverside Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912305202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WEST LEMON STREET",
            "address_2": "C/O FOCUS MANAGEMENT GROUP",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091103",
            "telephone_number": "813-281-0062",
            "fax_number": "813-281-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 ALEXANDER ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311305",
            "telephone_number": "360-736-2823",
            "fax_number": "360-736-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG ALEXANDER STREET WASHINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittyn J Flick, BS
• Christine Louise Flinton
• Alexandra Flowerdew
• Floyd D Smith, MD, Internal Medicine, PS
• Margaret Fowler Floyd
• Katherine Fogde, BAS, R-AAC
• Taelor Charmaine Folley
• Foot and Ankle Surgical Associates
• Andrew Charles Fosnacht, RN
• Sydney Fountain, PA-C

• Skilled Nursing Facility in Centralia, WA
• Providers in Centralia, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.