NPIMap

Organization Active NPI

Wesleyan Village

  • Assisted Living Facility
  • Elyria, OH
National Provider Identifier
1194283663
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WESLEYAN VILLAGE
Practice address
807 West Ave
Elyria, OH 44035-5898
Phone
(440) 284-9000
Fax
(440) 284-9636
NPI assigned
Mar 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Authorized official

Name
Elan Ruggill
Title
President
Phone
(734) 222-5275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

807 West Ave
Elyria, OH 44035-5898

Mailing address

807 West Ave
Elyria, OH 44035-5898
Phone (440) 284-9000

Other identifiers 1

IdentifierTypeStateIssuer
2527751MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1194283663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 WEST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355898",
            "telephone_number": "440-284-9000",
            "fax_number": "440-284-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 WEST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355898",
            "telephone_number": "440-284-9000",
            "fax_number": "440-284-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEYAN VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "RUGGILL",
        "authorized_official_first_name": "ELAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-222-5275"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2527751",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.