NPIMap

Organization Active NPI

Brookdale Senior Living Communities Inc

  • Assisted Living Facility
  • Beavercreek, OH
National Provider Identifier
1194068569
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
2196R Issued in OH
Legal business name
BROOKDALE SENIOR LIVING COMMUNITIES INC
Practice address
3839 Indian Ripple Rd
Beavercreek, OH 45440-3468
Phone
(937) 431-0455
Fax
(937) 431-0435
NPI assigned
Apr 3, 2013
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Joanne K Leskowicz
Title
Senior Vice President
Phone
(414) 918-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2196R OH Primary

Addresses

Primary practice location

3839 Indian Ripple Rd
Beavercreek, OH 45440-3468

Mailing address

3839 Indian Ripple Rd
Beavercreek, OH 45440-3468
Phone (937) 431-0455

Other identifiers 1

IdentifierTypeStateIssuer
3122838MedicaidOH

Other names 1

  • Brookdale Beavercreek 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
36D2069425Brookdale Beavercreek3839 Indian Ripple Blvd, Beavercreek, OH 45440Certificate of waiverNov 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brookdale Senior Living Communties Inc248 organizations share this tax ID, including this one
Part of
Brookdale Senior Living Inc

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1194068569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 INDIAN RIPPLE RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403468",
            "telephone_number": "937-431-0455",
            "fax_number": "937-431-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 INDIAN RIPPLE RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454403468",
            "telephone_number": "937-431-0455",
            "fax_number": "937-431-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE SENIOR LIVING COMMUNITIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2013-04-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2196R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3122838",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Beavercreek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.