BD Camelot Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BD CAMELOT OPCO, LLC

Doing business as

Brookdale Camelot Medina

Practice address

49 Leisure LN
Medina, OH 44256-1285

Phone

(330) 723-5825

NPI assigned

Jul 11, 2024

Organization subpart

No

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

Authorized official

Name

Anna Munoz

Title

Assistant Secretary

Phone

(615) 221-2250

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Camelot Medina Doing business as

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1083451512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 LEISURE LN",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561285",
            "telephone_number": "330-723-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 LEISURE LN",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561285",
            "telephone_number": "330-723-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BD CAMELOT OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "615-221-2250"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Camelot Medina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kecia Bauer
• Thomas Michael Bauer, R.PH.
• Nicole Baum, LSW
• Karen S Bauman, LISW-S
• BCC Medina Operations, LLC (Elmcroft of Medina)
• BD Medina South Opco LLC (Brookdale Medina South)
• BD Medina South Opco, LLC
• Brooke Beans
• Hailey Beard, LMHC
• Mahina Lokelani Beates

• Assisted Living Facility in Medina, OH
• Providers in Medina, 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 Jul 11, 2024; 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.