CHP Tega Cay SC Tenant Corp

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCF-0964 Issued in SC

Legal business name

CHP TEGA CAY SC TENANT CORP

Practice address

111 Wellmore Dr
Tega Cay, SC 29708-0039

Phone

(803) 835-7000

NPI assigned

Aug 3, 2015

Last updated

Nov 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin R Maddron

Title

Sr Vice President

Phone

(407) 540-7652

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1992181812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013383",
            "telephone_number": "407-540-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WELLMORE DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297080039",
            "telephone_number": "803-835-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHP TEGA CAY SC TENANT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "MADDRON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "407-540-7652"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "SC",
            "license": "NCF-0964",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF-0964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.