Renaissance Rehabilitation of South Jordan

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RENAISSANCE REHABILITATION OF SOUTH JORDAN

Practice address

1371 West South Jordan Parkway
South Jordan, UT 84095

Phone

(801) 920-9566

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Shad Crookston

Title

Executive Director

Phone

(801) 920-9566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1982812459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 RAYMOND RD",
            "city": "FRUIT HEIGHTS",
            "state": "UT",
            "postal_code": "840372249",
            "telephone_number": "801-444-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 WEST SOUTH JORDAN PARKWAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-920-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE REHABILITATION OF SOUTH JORDAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "CROOKSTON",
        "authorized_official_first_name": "SHAD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-920-9566"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.