Mary Scott Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4241 Issued in OH

Legal business name

MARY SCOTT NURSING HOME, INC.

Practice address

3109 Campus Drive
Dayton, OH 45406

Phone

(937) 278-0761

Fax

(937) 278-6482

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sue D. Ducker

Title

Business Office Manager

Phone

(937) 278-0761

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1114932852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 CAMPUS DRIVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45406",
            "telephone_number": "937-278-0761",
            "fax_number": "937-278-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 CAMPUS DRIVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45406",
            "telephone_number": "937-278-0761",
            "fax_number": "937-278-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY SCOTT NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "DUCKER",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "937-278-0761",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4241",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120210",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Dayton, OH
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• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.