NPIMap

Organization Active NPI

Brooklyn United Methodist Church Home - Adhc

  • Skilled Nursing Facility
  • Brooklyn, NY
National Provider Identifier
1093105835
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7001308N Issued in NY
Legal business name
BROOKLYN UNITED METHODIST CHURCH HOME - ADHC
Practice address
1485 Dumont Ave
Brooklyn, NY 11208-4705
Phone
(718) 827-4500
Fax
(718) 827-7719
NPI assigned
Feb 2, 2015
Last updated
Feb 2, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKLYN UNITED METHODIST CHURCH HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Sandra D Pitterson
Title
Cfo
Phone
(718) 827-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7001308N NY Primary

Addresses

Primary practice location

1485 Dumont Ave
Brooklyn, NY 11208-4705

Mailing address

1485 Dumont Ave
Brooklyn, NY 11208-4705
Phone (718) 827-4500

Other identifiers 1

IdentifierTypeStateIssuer
02324225MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Brooklyn United Methodist Church Home-Adc Social3 organizations share this tax ID, including this one
Part of
Brooklyn United Methodist Church Home-Adc Social

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1093105835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 DUMONT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084705",
            "telephone_number": "718-827-4500",
            "fax_number": "718-827-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 DUMONT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084705",
            "telephone_number": "718-827-4500",
            "fax_number": "718-827-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN UNITED METHODIST CHURCH HOME - ADHC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKLYN UNITED METHODIST CHURCH HOME",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "PITTERSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-827-4500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7001308N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02324225",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.