Carolyn Boone Lewis Health Care Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

B131064 Issued in DC

Legal business name

CAROLYN BOONE LEWIS HEALTH CARE CENTER INC

Practice address

1380 Southern Ave SE
Washington, DC 20032-4623

Phone

(202) 279-5828

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Joseph B Tucker

Title

Sr Vice President/Cfo

Phone

(301) 686-9010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Greater Southeast Community Center for the Aging Inc Former legal business name

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1124162300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-279-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "202-279-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN BOONE LEWIS HEALTH CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SR VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "301-686-9010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "DC",
            "license": "B131064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022869900",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Southeast Community Center for the Aging Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Caroline Berman DMD PA
• Antonelle D Caroline
• Barbara Caroline
• Boghuma Caroline
• Helen Caroline
• Michael Anthony Carome, M.D.
• Andrew Carpenter
• Barbara Anne Carpenter, MSW, LICSW
• Chloe Eve Carpenter, C-AA
• Gabrielle Dawn Carpenter, LGPC

• Skilled Nursing Facility in Washington, DC
• Providers in Washington, DC by specialty
• Skilled Nursing Facility in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.