Village at Marymount

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2295N Issued in OH

Legal business name

VILLAGE AT MARYMOUNT

Doing business as

Clare Hall

Practice address

5300 Marymount Village Drive
Garfield Heights, OH 44125-2938

Phone

(216) 587-8627

Fax

(216) 587-8967

NPI assigned

Jul 22, 2006

Last updated

Jun 19, 2008By 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

Mr. Jeffry A Myers

Title

Chief Operating Officer

Phone

(216) 587-8627

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clare Hall Doing business as

Locations

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1073534210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MARYMOUNT VILLAGE DRIVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-587-8627",
            "fax_number": "216-587-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MARYMOUNT VILLAGE DRIVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252938",
            "telephone_number": "216-587-8627",
            "fax_number": "216-587-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE AT MARYMOUNT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JEFFRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "216-587-8627",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2295N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2705504",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clare Hall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Garfield Heights, OH
• Providers in Garfield Heights, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.