CCM Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CCM OPERATIONS, LLC

Practice address

1127 Timber Run Dr
Saint Louis, MO 63146-4482

Phone

(314) 434-8361

NPI assigned

Apr 13, 2020

Organization subpart

No

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

Authorized official

Name

Benjamin M Klein

Title

Authorized Person

Phone

(201) 470-5751

Specialties & licenses 1

Addresses

Other names 1

• Creve Coeur Manor Doing business as

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1942829692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY PLZ STE 500",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016203",
            "telephone_number": "201-470-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 TIMBER RUN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464482",
            "telephone_number": "314-434-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCM OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED  PERSON",
        "authorized_official_telephone_number": "201-470-5751"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creve Coeur Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, 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 Apr 13, 2020; 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.