Buckeye C, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020312 Issued in CO

Legal business name

BUCKEYE C, LLC

Doing business as

Riverdale Rehab and Care Community of Brighton

Practice address

2311 E Bridge Street
Brighton, CO 80601-2547

Phone

(303) 659-2253

Fax

(303) 659-6334

NPI assigned

Oct 31, 2005

Last updated

Sep 20, 2017By 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

Mary Koretke

Title

Director of Reimbursement

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Riverdale Rehab and Care Community of Brighton Doing business as

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1992796874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12136 W. BAYAUD AVENUE",
            "address_2": "SUITE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282115",
            "telephone_number": "303-238-3838",
            "fax_number": "303-987-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 E BRIDGE STREET",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012547",
            "telephone_number": "303-659-2253",
            "fax_number": "303-659-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE C, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02130271",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverdale Rehab and Care Community of Brighton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Elizabeth Brown
• Lisa Brown, CMT/LMT
• Lane Marie Bryant, PA-C
• Buckeye C, LLC (Cottonwood Care Center)
• Buckeye C, LLC (Riverdale Rehab and Care of Brighton)
• Buffalini Primary Care, LLC
• Michelle Buffalini, CRNP
• Kaydee Bullock, OTR/L
• Michelle Grace Tatko Bullock, M.A. CCC-SLP
• Susan Anne Bundschuh, OTR/L

• Skilled Nursing Facility in Brighton, CO
• Providers in Brighton, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.