Parkside Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10278 Issued in FL

Legal business name

PARKSIDE ASSISTED LIVING

Practice address

329 N Church St
Starke, FL 32091-3434

Phone

(904) 964-2220

NPI assigned

Jun 20, 2013

Organization subpart

No

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

Authorized official

Name

John Miller

Title

Owner

Phone

(904) 964-2220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1093154346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N CHURCH ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 N CHURCH ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913434",
            "telephone_number": "904-964-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-964-2220"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "10278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ottey Bone and Joint Associates LLC
• Andrew Lyn Owen, PA
• Dana Padgett, OTR/L
• Sunil Choudary Paladugu
• Roslyn Denise Parker
• Parkside Assisted Living
• Jaimee Patterson
• Barbara Pellechio
• Anne Louise Perantoni, ARNP, MSN, BC
• Gabrielle Perez, PA-C

• Assisted Living Facility in Starke, FL
• Providers in Starke, 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 Jun 20, 2013; 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.