NPIMap

Organization Active NPI

Summerville at Outlook Manor, LLC

Doing business as Summerville at Outlook Manor

  • Assisted Living Facility
  • Westerville, OH
National Provider Identifier
1144557687
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
2284R Issued in OH
Legal business name
SUMMERVILLE AT OUTLOOK MANOR, LLC
Doing business as
Summerville at Outlook Manor
Practice address
690 Cooper Rd
Westerville, OH 43081-8919
Phone
(614) 794-2499
Fax
(614) 794-2611
NPI assigned
Nov 4, 2009
Last updated
Nov 4, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMERVILLE SENIOR LIVING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Authorized official

Name
Noelle Diaz Bickel
Title
Licensing Specialist
Phone
(206) 298-2909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2284R OH Primary
Alzheimer Center (Dementia Center) 311500000X 2284R OH

Addresses

Primary practice location

690 Cooper Rd
Westerville, OH 43081-8919

Mailing address

3131 Elliott Ave
Suite 500
Seattle, WA 98121-1044
Phone (206) 298-2909

Other names 1

  • Summerville at Outlook Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summerville at Chestnut Hill LLC12 organizations share this tax ID, including this one
Part of
Summerville at Chestnut Hill LLC

Other organizations with this tax ID 11

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": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1144557687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 COOPER RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818919",
            "telephone_number": "614-794-2499",
            "fax_number": "614-794-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT OUTLOOK MANOR, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERVILLE SENIOR LIVING, INC.",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2284R",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OH",
            "license": "2284R",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerville at Outlook Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

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