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Organization Active NPI

Wellington Estates Inc

Doing business as St Charles/St James Place

  • Intellectual Disabilities Intermediate Care Facility
  • Wellington, OH
National Provider Identifier
1144488099
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
WELLINGTON ESTATES INC
Doing business as
St Charles/St James Place
Practice address
101 Weber CT
Wellington, OH 44090
Phone
(440) 647-2088
NPI assigned
May 28, 2008
Last updated
Oct 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Authorized official

Name
Mr. Adelbert H Weber
Title
Administrator
Phone
(440) 647-2088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

101 Weber CT
Wellington, OH 44090

Mailing address

PO Box 386
Wellington, OH 44090-0386
Phone (440) 647-2088

Other identifiers 4

IdentifierTypeStateIssuer
36-G658OtherOHCMS CERTIFICATION NUMBER
4710085OtherOHODMR/DD FACILITY NO.
12480OtherOHMR/DD LICENSE NO.
0067898OtherOHOHIO MEDICAID PROVIDER NUMBER

Other names 1

  • St Charles/St James Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Boardwalk Parkplace2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1144488099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "440900386",
            "telephone_number": "440-647-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WEBER CT",
            "city": "WELLINGTON",
            "state": "OH",
            "postal_code": "44090",
            "telephone_number": "440-647-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLINGTON ESTATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "ADELBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "440-647-2088",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATION NUMBER",
            "identifier": "36-G658",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODMR/DD FACILITY NO.",
            "identifier": "4710085",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MR/DD LICENSE NO.",
            "identifier": "12480",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID PROVIDER NUMBER",
            "identifier": "0067898",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Charles/St James Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.