Organization Active NPI

The Blake at Oxford

  • Assisted Living Facility
  • Oxford, MS
National Provider Identifier
1023519766
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
1204
Legal business name
THE BLAKE AT OXFORD
Practice address
110 Ed Perry Blvd
Oxford, MS 38655-3452
Phone
(662) 234-5050
NPI assigned
Feb 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Perian Petcher
Title
Regional Director of Operations
Phone
(980) 275-0974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 1204 Primary

Addresses

Primary practice location

110 Ed Perry Blvd
Oxford, MS 38655-3452

Mailing address

110 Ed Perry Blvd
Oxford, MS 38655-3452
Phone (662) 234-5050

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1023519766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ED PERRY BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553452",
            "telephone_number": "662-234-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ED PERRY BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553452",
            "telephone_number": "662-234-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLAKE AT OXFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "PETCHER",
        "authorized_official_first_name": "PERIAN",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "980-275-0974"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": "1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.