Westridge Gardens Nursing & Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030380 Issued in MO

Legal business name

WESTRIDGE GARDENS NURSING & REHABILITATION CENTER, LLC

Practice address

11901 Jessica LN
Raytown, MO 64138-2639

Phone

(816) 358-3535

Fax

(816) 358-3638

NPI assigned

Aug 31, 2005

Organization subpart

No

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

Authorized official

Name

Joseph C Tutera

Title

Operator

Phone

(816) 444-0900

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Westridge Gardens Rehabilitation & Health Care Center Doing business as

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1922092378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 JESSICA LN",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382639",
            "telephone_number": "816-358-3535",
            "fax_number": "816-358-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 JESSICA LN",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382639",
            "telephone_number": "816-358-3535",
            "fax_number": "816-358-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTRIDGE GARDENS NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "TUTERA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "816-444-0900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "90409-011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "90409-011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4434501",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101474609",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westridge Gardens Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Raytown, MO
• Providers in Raytown, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.