Carriage Inn of Trotwood, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1970N Issued in OH

Legal business name

CARRIAGE INN OF TROTWOOD, INC

Doing business as

Shiloh Springs Care Center

Practice address

3500 Shiloh Springs Rd
Trotwood, OH 45426-2260

Phone

(937) 854-1180

NPI assigned

Nov 14, 2007

Last updated

Dec 17, 2007By 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. Ken Bernsen

Title

President

Phone

(937) 277-0505

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shiloh Springs Care Center Doing business as

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1114107596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 PHILADELPHIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153653",
            "telephone_number": "937-277-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SHILOH SPRINGS RD",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262260",
            "telephone_number": "937-854-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRIAGE INN OF TROTWOOD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "BERNSEN",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-277-0505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1970N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773146",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shiloh Springs Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Markeida Nikkole Brown
• Dana Bruner
• Shawnda Renea Buckner, LPN
• Carolyn Marie Buisson, M.A., CCC-SLP
• Danyal Lashai Burns, LPN
• Charlene Chambers
• Denise Chattams
• Sonja Renee Cherry
• City of Trotwood
• Clean Slate Sober Living

• Skilled Nursing Facility in Trotwood, OH
• Providers in Trotwood, 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 Dec 17, 2007; 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.