Organization Active NPI

Ocoee1818 Opco, LLC

  • Assisted Living Facility
  • Ocoee, FL
National Provider Identifier
1164052551
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
OCOEE1818 OPCO, LLC
Practice address
80 N Clarke Rd
Ocoee, FL 34761-9163
Phone
(407) 299-2170
NPI assigned
Jan 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Authorized official

Name
Joanne Grzybowski
Title
Controller
Phone
(706) 691-9308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

80 N Clarke Rd
Ocoee, FL 34761-9163

Mailing address

80 N Clarke Rd
Ocoee, FL 34761-9163
Phone (407) 299-2170

Other names 1

  • Madison at Ocoee Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0965538Madison at Ocoee80 N Clarke Rd, Ocoee, FL 34761Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1164052551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N CLARKE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347619163",
            "telephone_number": "407-299-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N CLARKE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347619163",
            "telephone_number": "407-299-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOEE1818 OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "GRZYBOWSKI",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "706-691-9308"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison at Ocoee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.