1415 Fort Clarke Blvd Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

1415 FORT CLARKE BLVD TENANT LLC

Doing business as

The Gables of Gainesville

Practice address

1415 Fort Clarke Blvd
Gainesville, FL 32606-7181

Phone

(352) 332-4505

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By 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

Sharon Makowsky

Title

Authorized Representative

Phone

(419) 247-2800

Specialties & licenses 2

Addresses

Other names 1

• The Gables of Gainesville Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1174351183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 E 21ST ST N STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062959",
            "telephone_number": "316-616-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 FORT CLARKE BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067181",
            "telephone_number": "352-332-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1415 FORT CLARKE BLVD TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "MAKOWSKY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "419-247-2800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Gables of Gainesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.