SANDRA RAE DIVINE


Address: 1015 Lancaster Dr, Stockton, MO 65785-8360
Phone: 4172764531

SANDRA RAE DIVINE (NPI# 1932507431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932507431
Entity Type Individual
Full Name SANDRA RAE DIVINE
Credential P.T.A
Practice Address 1015 Lancaster Dr
Stockton
MO 65785-8360
Practice Telephone 4172764531
Mailing Telephone 4172764531
Enumeration Date 2014-12-15
Last Update Date 2014-12-15
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility 115167 MO Nursing & Custodial Care Facilities

Office Location

Street Address 1015 LANCASTER DR
City STOCKTON
State MO
Zip Code 65785-8360

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891017356 Debbie Lynn Haines Pharmacy Technician 19 Public Square, Stockton, MO 65785 2010-02-24
1316003759 Cheryl Thornton Psychologist 808 South St, Stockton, MO 65785 2006-12-29
1336192582 Rodger S Campbell Emergency Medicine 106 West Blair Drive, Stockton, MO 65785 2006-05-18
1134109713 Citizens Memorial Health Care Foundation Skilled Nursing Facility 811 Owens Mill Rd, Stockton, MO 65785 2006-01-19
1376865865 Katherine Marie Hicks Pharmacy Technician 19 Public Square, Stockton, MO 65785 2010-02-24
1639212608 Stockton R-i School District Physical Therapist 906 South St, Stockton, MO 65785 2007-02-15
1114249752 Karen Sue Purtle Pharmacist 19 Public Square, Stockton, MO 65785-0189 2010-02-24
1801921366 Emily F Green Speech-Language Pathologist 906 Sout St, Stockton R-i School District, Stockton, MO 65785-0190 2007-02-23
1942223649 Troy Devon Evans Chiropractor 107 W Hwy 32, Suite D, Stockton, MO 65785-0384 2006-07-25
1962683524 Craig Maxwell, D.d.s., P.C. Dentist 201 West Smith Drive, Stockton, MO 65785-0609 2007-11-23
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(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.

Providers in the same taxonomy and city

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1114323136 Good Samaritan Care Provider LLC Skilled Nursing Facility 10740 Oakwilde Ave, Stockton, CA 95212-9249 2014-11-19
1801938816 Covenant Care California, LLC Skilled Nursing Facility 9289 Branstetter Place, Stockton, CA 95209-1700 2007-02-13
1730269184 O'connor Woods Housing Corp Skilled Nursing Facility 3110 Wagner Heights Rd, Stockton, CA 95209-4848 2006-10-17
1891700464 Kindred Nursing Centers West, LLC Skilled Nursing Facility 1517 E Knickerbocker Dr, Stockton, CA 95210-3119 2006-07-30
1548283542 Stockton Edison Healthcare Corporation Skilled Nursing Facility 1630 N. Edison St., Stockton, CA 95204 2006-07-25
1871512046 Helios Healthcare, LLC Skilled Nursing Facility 442 E Hampton St, Stockton, CA 95204-5519 2006-07-19
1922027002 Helios Healthcare, LLC Skilled Nursing Facility 6940 Pacific Ave, Stockton, CA 95207-2602 2006-07-19
1487601704 Sunbridge Stockton Rehabilitation Center LLC Skilled Nursing Facility 9107 Davis Rd, Stockton, CA 95209-1807 2006-05-30
1679529176 Beverly Health and Rehabilitation Services, Inc. Skilled Nursing Facility 1221 Rosemarie Ln, Stockton, CA 95207-6703 2006-05-26
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City STOCKTON
Zip Code 65785

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Dataset Information

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.

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