PACIFIC CARE CENTER LLC (NPI# 1801038724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801038724 |
| Entity Type | Organization |
| Organization Name | PACIFIC CARE CENTER LLC |
| Practice Address |
105 South Sixth Street Pacific MO 63069 |
| Practice Telephone | 6362714222 |
| Practice Fax Number | 6362578002 |
| Mailing Telephone | 6362714222 |
| Mailing Fax Number | 6362578002 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2012-10-24 |
| Authorized Official Name | MRS. GRETCHEN R ROBERTS-HOAGLIN (ADMINISTRATOR) |
| Authorized Official Telephone | 6362714222 |
| Authorized Official Credential | R.N. LICENSED NU |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 036467 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 102343001 | 05 |
| Street Address |
105 SOUTH SIXTH STREET |
| City | PACIFIC |
| State | MO |
| Zip Code | 63069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558884262 | Nicole Lynn Sitton | Occupational Therapist | 315 North 1st Street, Pacific, MO 63069 | 2017-07-25 |
| 1891222022 | Melissa Marie Georgevitch | Chiropractor | 724 W Osage St, Pacific, MO 63069 | 2017-05-18 |
| 1912238254 | Jeannine Lisa Liebmann | Counselor | 791 New Beginnings Dr., Pacific, MO 63069 | 2010-01-27 |
| 1649428152 | Evelyn Alice Sdrulla | Physician Assistant | 300 North First St, Premier Medical Associates, Pacific, MO 63069 | 2008-09-09 |
| 1790106011 | Shawna Jo Surman | Nurse Practitioner | 307 Noonan Dr, Pacific, MO 63069 | 2014-01-05 |
| 1619371077 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2120 W Osage St, Pacific, MO 63069-1101 | 2014-10-14 |
| 1568811461 | Crystal Welch | Nurse Practitioner | 2120 W Osage St, Pacific, MO 63069-1101 | 2016-06-10 |
| 1902016959 | Sandra Joy Winder | Social Worker | 160 Western Ave, Pacific, MO 63069-1115 | 2007-05-22 |
| 1649577198 | Jennifer L Schmidt | Nurse Practitioner | 307 Noonan Drive, Pacific, MO 63069-1118 | 2011-02-18 |
| 1811046584 | Cary William Ulbrich | Dentist | 308 Noonan Dr, Suite E, Pacific, MO 63069-1118 | 2007-01-10 |
| Find all providers in zip 63069 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316947401 | Pcc Investments, Inc. | Skilled Nursing Facility | 105 S 6th St, Pacific, MO 63069-1328 | 2005-07-29 |
| 1265091755 | Pacific Manor LLC | Skilled Nursing Facility | 105 S 6th St, Pacific, MO 63069-1328 | 2019-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609492719 | Ignite Medical Resort Independence LLC | Skilled Nursing Facility | 20511 E. Trinity Pl., Blue Springs, MO 64015 | 2020-06-24 |
| 1760006308 | Sunterra Dardenne Prairie Oc LLC | Skilled Nursing Facility | 7275 Highway N, Dardenne Prairie, MO 63368-7126 | 2020-05-29 |
| 1184247215 | Berry Medical Properties, LLC | Skilled Nursing Facility | 11380 Natural Bridge Rd, Bridgeton, MO 63044-2307 | 2020-05-23 |
| 1881249464 | Rolla Grand LLC | Skilled Nursing Facility | 1800 White Columns Dr, Rolla, MO 65401-2044 | 2019-08-09 |
| 1184276982 | Willow Health Care Inc | Skilled Nursing Facility | 712 Copper Rock Dr, Rogersville, MO 65742-8970 | 2019-07-11 |
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1518436724 | Missouri Nursing & Rehab LLC | Skilled Nursing Facility | 783 Weber Road, Farmington, MO 63640-3318 | 2018-11-16 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1578039467 | Laverna Senior Living LLC | Skilled Nursing Facility | 904 S Hall Ave, Savannah, MO 64485-1952 | 2018-10-17 |
| 1093297152 | Community Care Center of Union Inc | Skilled Nursing Facility | 1080 Marie Lane, Union, MO 63084 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.