Randolph Hills Nursing Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

15025 Issued in MD

Legal business name

RANDOLPH HILLS NURSING CARE, INC.

Practice address

4011 Randolph Rd
Wheaton, MD 20902-1000

Phone

(301) 933-2500

Fax

(301) 942-6992

NPI assigned

Jan 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jung Hee Lee, NHA

Title

Administrator

Phone

(301) 933-2500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Randolph Hills Nursing Center Doing business as

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1922087451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 RANDOLPH RD",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209021000",
            "telephone_number": "301-933-2500",
            "fax_number": "301-942-6992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 RANDOLPH RD",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209021000",
            "telephone_number": "301-933-2500",
            "fax_number": "301-942-6992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH HILLS NURSING CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JUNG HEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-933-2500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "15025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065422100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randolph Hills Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Wheaton, MD
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.