Extended Hearts LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EXTENDED HEARTS LLC

Practice address

722 Blackmoat PL
Miamisburg, OH 45342-2725

Phone

(937) 287-7472

NPI assigned

Sep 11, 2017

Last updated

Sep 11, 2017By 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

Carmen JoinerNPI 1205288339

Title

Ceo

Phone

(937) 287-7472

Specialties & licenses 10

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carmen Joiner

  • Nursing Home Administrator
  • Miamisburg, OH
  • NPI 1205288339
  NPD Authorized official

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1043739139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BECKLEY FARM WAY",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450667508",
            "telephone_number": "947-287-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 BLACKMOAT PL",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453422725",
            "telephone_number": "937-287-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED HEARTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "JOINER",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-287-7472"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0196030",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Osayi Marion Ero, LPN
• Raelyn Espitia, RBT
• Elizabeth Evans
• Jason Evans, LPN
• Olivia Evans
• Carla Ezerski, RBT
• Serena Christine Fadell, MD
• Alan Fark, MD
• Jennifer Farris, MOTR/L
• Frank J Fasano Jr., M.D.

• Assisted Living Facility in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.