Maple Ridge Manor, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ACL0000000212 Issued in TN

Legal business name

MAPLE RIDGE MANOR, INC

Doing business as

Maple Ridge Assisted Living

Practice address

705 Lake Rd
Dyersburg, TN 38024-2918

Phone

(731) 286-6725

Fax

(731) 286-6977

NPI assigned

Nov 14, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Bill Ables

Title

Administrator

Phone

(731) 286-6725

Specialties & licenses 1

Addresses

Other names 1

• Maple Ridge Assisted Living Doing business as

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1144650045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 LAKE RD",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242918",
            "telephone_number": "731-286-6725",
            "fax_number": "731-286-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LAKE RD",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242918",
            "telephone_number": "731-286-6725",
            "fax_number": "731-286-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RIDGE MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "ABLES",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "731-286-6725",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TN",
            "license": "ACL0000000212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Ridge Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ravinder K Machra, MD
• Katherine Lisko Madden
• Robert Walter Magee, MD
• Ross E Maldonado, PT
• Thomas Earl Manning, O.D.
• Julie Markham, R.N.
• Kristen Nicole Massey, MSN, APRN, FNP-C
• Katie May
• Catherine Kellee McBride, PT
• Kelly M McCallum, APN

• Assisted Living Facility in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Assisted Living Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.