NPIMap

Organization Active NPI

KKJ Enterprises, Inc

  • Skilled Nursing Facility
  • Portsmouth, OH
National Provider Identifier
1972500692
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KKJ ENTERPRISES, INC
Practice address
1319 Spring Street
Portsmouth, OH 45662
Phone
(740) 354-6619
Fax
(740) 354-5710
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Ms. Carol Sue Sauer
Title
Administrator
Phone
(740) 354-6619

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X
Skilled Nursing Facility 314000000X OH Primary

Addresses

Primary practice location

1319 Spring Street
Portsmouth, OH 45662

Mailing address

PO Box 439
1319 Spring Street
Portsmouth, OH 45662
Phone (740) 354-6619

Other identifiers 3

IdentifierTypeStateIssuer
2335155MedicaidOH
134209136OtherOHINSURANCE COMPANIES
0060574MedicaidOH

Other names 1

  • Crystal Care Center of Portsmouth Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1972500692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 439",
            "address_2": "1319 SPRING STREET",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-354-6619",
            "fax_number": "740-353-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SPRING STREET",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-354-6619",
            "fax_number": "740-354-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KKJ ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "SAUER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "740-354-6619",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2335155",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE COMPANIES",
            "identifier": "134209136",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060574",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Care Center of Portsmouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.