Othello Nursing & Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OTHELLO NURSING & REHAB LLC

Practice address

495 N 13TH Ave
Othello, WA 99344-1215

Phone

(509) 488-9609

NPI assigned

Nov 30, 2022

Organization subpart

No

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

Authorized official

Name

Chaim Wolmark

Title

Manager

Phone

(253) 251-9300

Specialties & licenses 1

Addresses

Other names 1

• Othello Care Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy A Berg, M.D.

  • Vascular Surgery Physician
  • Spokane Valley, WA
  • NPI 1376637421
  NPD (past)
• Gary G Gularte, M.D.

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1174665913
  NPD (past)

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1972213932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 ROSEDALE ST STE 200",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH AVE",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441215",
            "telephone_number": "509-488-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTHELLO NURSING & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "WOLMARK",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "253-251-9300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Othello Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Othello Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven A Nash, LMP
• Dien V Nguyen, DDS
• Gloria Ochoa
• Othello Chiropractic PS
• Othello Dental Arts Clinic, P.S.
• Othello School District
• Othello Senior Care LLC.
• Karen Palmer, LPN
• Marysol Ozuna Parrish, ATC
• Rebecca Pendell, LMHC

• Skilled Nursing Facility in Othello, WA
• Providers in Othello, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.