NPIMap

Organization Active NPI

Five Magnolias Assisted Living

  • Assisted Living Facility (Mental Illness)
  • Lithia, FL
National Provider Identifier
1013337286
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
AL12457 Issued in FL
Legal business name
FIVE MAGNOLIAS ASSISTED LIVING
Practice address
6116 Audubon Manor Blvd
Lithia, FL 33547-5031
Phone
(813) 486-0702
Fax
(813) 315-8965
NPI assigned
Apr 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Authorized official

Name
Ms. Sharon J Johnson, MSNPI 1083095004
Title
Administrator
Phone
(813) 486-0702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X AL12457 FL Primary

Addresses

Primary practice location

6116 Audubon Manor Blvd
Lithia, FL 33547-5031

Mailing address

6116 Audubon Manor Blvd
Lithia, FL 33547-5031
Phone (813) 486-0702

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1013337286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 AUDUBON MANOR BLVD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475031",
            "telephone_number": "813-486-0702",
            "fax_number": "813-315-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 AUDUBON MANOR BLVD",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475031",
            "telephone_number": "813-486-0702",
            "fax_number": "813-315-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE MAGNOLIAS ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-486-0702",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL12457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.