Hampton Deerwood Alf, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HAMPTON DEERWOOD ALF, LLC

Practice address

1810 SE 16TH Ave
Ocala, FL 34471-4642

Phone

(352) 387-1046

Fax

(352) 433-0728

NPI assigned

Aug 12, 2022

Organization subpart

No

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

Authorized official

Name

Peder Johnsen

Title

Ceo

Phone

(352) 387-1830

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1043948300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SE 18TH ST STE 902",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715445",
            "telephone_number": "352-387-1830",
            "fax_number": "352-433-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 SE 16TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714642",
            "telephone_number": "352-387-1046",
            "fax_number": "352-433-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMPTON DEERWOOD ALF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSEN",
        "authorized_official_first_name": "PEDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-387-1830"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114712700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ahmed Hamodi, MD
• Hampton 24TH Road Alf, LLC
• Hampton Alf at 24TH Road, LLC
• Hampton Alf at 24TH Road, LLC
• Hampton Alf at Deerwood, LLC
• Hampton Manor Gardens Inc
• Hampton Manor Inc
• Hampton Manor of Deerwood LLC
• Hampton Manor of Pasco Inc
• Hampton MGMT. Corp of Belleview

• Assisted Living Facility in Ocala, FL
• Providers in Ocala, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.