SSC Montgomery Woodley Manor Opr Co. LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12656 Issued in AL

Legal business name

SSC MONTGOMERY WOODLEY MANOR OPR CO. LLC

Practice address

3312 Woodley Rd
Montgomery, AL 36116-3155

Phone

(334) 288-2780

Fax

(334) 288-7217

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodley Manor Health and Rehabilitation Doing business as

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1932216488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 WOODLEY RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361163155",
            "telephone_number": "334-288-2780",
            "fax_number": "334-288-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC MONTGOMERY WOODLEY MANOR OPR CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4750370S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodley Manor Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristi Springer, CRNP
• Courtney Sprinkle, PT, DPT
• Keerthi Venkata Sreeramoju, MD
• SSC Montgomery Cedar Crest Operating Company LLC
• SSC Montgomery South Haven Operating Company LLC
• Johanna Marie St Bernard
• Luther St James IV, M.D.
• St. Jude Catholic Hospital
• Laura Jenelle Stabin, M.D.
• Aubrey Ayers Stabler Jr., M.D

• All providers in Montgomery, AL
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.