Organization Active NPI

Country View Manor Inc

  • Skilled Nursing Facility
  • Provo, UT
National Provider Identifier
1962543355
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COUNTRY VIEW MANOR INC
Practice address
2901 W Center St
Provo, UT 84601-3659
Phone
(801) 373-5079
Fax
(801) 374-2855
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Authorized official

Name
Bryan Erickson
Title
Ceo
Phone
(801) 763-5040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2901 W Center St
Provo, UT 84601-3659

Mailing address

2901 W Center St
Provo, UT 84601-3659
Phone (801) 373-5079

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267401600000",
    "number": "1962543355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846013659",
            "telephone_number": "801-373-5079",
            "fax_number": "801-374-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846013659",
            "telephone_number": "801-373-5079",
            "fax_number": "801-374-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY VIEW MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-03-01",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-763-5040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.