Ronald R. Johnson

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

0671A003 Issued in NY

Legal business name

RONALD R. JOHNSON

Doing business as

Underwood Manor LLHCSA

Practice address

4460 Union Hill Rd
Hinsdale, NY 14743-9715

Phone

(716) 557-2322

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By 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

Mr. Ronald Ray Johnson

Title

Owner

Phone

(716) 595-8784

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Underwood Manor LLHCSA Doing business as

Tax ID family

Johnson Llhcsa Forestville3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ronald R. Johnson

  dba Johnson LLHCSA Forestville

  • Adult Care Home Facility
  • Forestville, NY
  • NPI 1477754703
  NPD tax ID
• Ronald R. Johnson

  dba Johnson LLHCSA Fredonia

  • Adult Care Home Facility
  • Fredonia, NY
  • NPI 1780885012
  NPD tax ID

Locations

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013125467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2063 ROUTE 83",
            "city": "FORESTVILLE",
            "state": "NY",
            "postal_code": "140629639",
            "telephone_number": "716-965-2644",
            "fax_number": "716-965-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 UNION HILL RD",
            "city": "HINSDALE",
            "state": "NY",
            "postal_code": "147439715",
            "telephone_number": "716-557-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD R. JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-595-8784",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NY",
            "license": "0671A003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02731313",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH LICENSE",
            "identifier": "0671A003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Underwood Manor LLHCSA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Caskey, RN
• Hinsdale Central School
• Hinsdale Fire District
• Ellen Loveless, LMHC
• Laurie Oliver, LMT
• Kathleen Anne Simon, M.A., CCC-LSLP
• Nathan Richard Smith, PHARMD, MFT
• Underwood Gardens, LLC (Willow Creek)

• Adult Care Home Facility in Hinsdale, NY
• Providers in Hinsdale, NY by specialty
• Adult Care Home Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.