McIntosh Assisted Living

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

AL10451 Issued in FL

Legal business name

MCINTOSH ASSISTED LIVING

Practice address

5650 NW 219TH Street Rd
Micanopy, FL 32667-7948

Phone

(352) 591-2503

NPI assigned

Jun 13, 2016

Last updated

Jun 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dorothy Robinson

Title

Owner

Phone

(352) 591-2503

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1154771905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 NW 219TH STREET RD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326677948",
            "telephone_number": "352-591-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 NW 219TH STREET RD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326677948",
            "telephone_number": "352-591-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-591-2503"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "AL10451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Goldberg, AP
• Lisa Hager
• Kelly Marie Johnston, RD
• Eric Lanham
• Anna Belen Larson, LM, CPM
• Mallory Leblanc Pfaffly, MD
• Caroline Roach, LCSW
• Irina Shlain, L.AC. A.P.
• Snickers&Giggles

• Health Maintenance Organization in Micanopy, FL
• Providers in Micanopy, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.