Genesis Health Ventures of Bloomfield, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1075-C Issued in CT

Legal business name

GENESIS HEALTH VENTURES OF BLOOMFIELD, INC

Doing business as

Kimberly Hall South

Practice address

1 Emerson Dr
Windsor, CT 06095-3204

Phone

(860) 688-6443

Fax

(860) 688-1259

NPI assigned

Jun 22, 2006

Organization subpart

No

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

Authorized official

Name

Jane Dropeskey

Title

Corporate Manager

Phone

(610) 925-4231

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Kimberly Hall South Doing business as

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1104862507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMERSON DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953204",
            "telephone_number": "860-688-6443",
            "fax_number": "860-688-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTH VENTURES OF BLOOMFIELD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "DROPESKEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "610-925-4231"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "1075-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "939502",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010751",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-MANAGED MEDICAID",
            "identifier": "000010751-00",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-CT",
            "identifier": "1890603",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "A950621",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-COMMERCIAL",
            "identifier": "718",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-HMO",
            "identifier": "177442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimberly Hall South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiara Garrett
• Amari Gary
• Genesis
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• Genesis Eldercare Physician Services LLC
• Genesis Health Ventures of Bloomfield, Inc
• Genesis Rehab Services
• Gentle Touch Homecare Services LLC
• Lianna Gerardi
• Tina Giallias

• Skilled Nursing Facility in Windsor, CT
• Providers in Windsor, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.