Organization Active NPI

Auburn Agt,LLC

  • Skilled Nursing Facility
  • Auburn, NY
National Provider Identifier
1124015664
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
AUBURN AGT,LLC
Practice address
85 Thornton Ave
Auburn, NY 13021-4654
Phone
(315) 253-7351
Fax
(315) 253-0300
NPI assigned
Sep 30, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Karol Prayne
Title
Administrator
Phone
(315) 253-7351

Corporate family (same tax ID) 1

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

National Provider Directory

National Provider Directory
Tax ID family
Auburn Agtllc (2 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

NPPES NPI Registry

Primary practice location

85 Thornton Ave
Auburn, NY 13021-4654

Mailing address

85 Thornton Ave
Auburn, NY 13021-4654
Phone (315) 253-7351

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00356212MedicaidNY

Other names 1

NPPES NPI Registry
  • Auburn Nursing Home Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124015664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 THORNTON AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214654",
            "telephone_number": "315-253-7351",
            "fax_number": "315-253-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 THORNTON AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214654",
            "telephone_number": "315-253-7351",
            "fax_number": "315-253-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN AGT,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRAYNE",
        "authorized_official_first_name": "KAROL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "315-253-7351",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00356212",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Auburn Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.