NPIMap

Organization Active NPI

1 Magnolia Drive Operations LLC

Doing business as La Plata Center

  • Skilled Nursing Facility
  • La Plata, MD
National Provider Identifier
1033391503
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
08-005 Issued in MD
Legal business name
1 MAGNOLIA DRIVE OPERATIONS LLC
Doing business as
La Plata Center
Practice address
1 Magnolia Dr
La Plata, MD 20646-9357
Phone
(301) 934-4001
Fax
(301) 934-6373
NPI assigned
Nov 27, 2007
Last updated
Aug 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Authorized official

Name
Michael T. Berg
Title
Assistant Secretary
Phone
(505) 468-4752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 08-005 MD Primary

Addresses

Primary practice location

1 Magnolia Dr
La Plata, MD 20646-9357

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436

Other identifiers 1

IdentifierTypeStateIssuer
413990900MedicaidMD

Other names 1

  • La Plata Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1033391503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAGNOLIA DR",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469357",
            "telephone_number": "301-934-4001",
            "fax_number": "301-934-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1 MAGNOLIA DRIVE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "08-005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413990900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Plata Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "La Plata Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.