Braddock Heights Healthcare, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10-005 Issued in MD

Legal business name

BRADDOCK HEIGHTS HEALTHCARE, LLC

Doing business as

Vindobona Nursing and Rehabilitation Center

Practice address

6012 Jefferson Blvd
Frederick, MD 21703-6953

Phone

(301) 371-7160

Fax

(301) 371-5921

NPI assigned

Feb 12, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Craig Taylor

Title

Chief Manager

Phone

(423) 308-1845

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vindobona Nursing and Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1134468150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 SHALLOWFORD RD",
            "address_2": "SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212780",
            "telephone_number": "423-308-1845",
            "fax_number": "423-308-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 JEFFERSON BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217036953",
            "telephone_number": "301-371-7160",
            "fax_number": "301-371-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADDOCK HEIGHTS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "423-308-1845",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "10-005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4215885 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vindobona Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jody Lynn Boyer, PTA-AS
• Suzanne Boyle, D.M.D.
• Krista Boynton, MCD CCC SLP
• Emily Bozzell, RD
• Morgan Elizabeth Brackett, CRNP
• Helena Brader, PA-C
• Latasha Branch, LGPC
• Steven J. Brand, M.D
• Brandy Lynn Brandenburg, LCSW-C
• David Charles Brandenburg, DDS

• Skilled Nursing Facility in Frederick, MD
• Providers in Frederick, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.