Sage Lakewood, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0565 Issued in CO

Legal business name

SAGE LAKEWOOD, LLC

Doing business as

Bethany Healthplex

Practice address

5301 W 1St Ave
Lakewood, CO 80226-2434

Phone

(303) 238-8333

Fax

(303) 238-0464

NPI assigned

Jan 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth B. Ross

Title

Secretary

Phone

(812) 422-7774

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bethany Healthplex Doing business as

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174501639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 W 1ST AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262434",
            "telephone_number": "303-238-8333",
            "fax_number": "303-238-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 W 1ST AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262434",
            "telephone_number": "303-238-8333",
            "fax_number": "303-238-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE LAKEWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "812-422-7774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056-52169",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethany Healthplex",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.