Leroy Village Green Residential Health Care Facility Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1823300N Issued in NY

Legal business name

LEROY VILLAGE GREEN RESIDENTIAL HEALTH CARE FACILITY INC

Practice address

10 Munson St
Le Roy, NY 14482-8933

Phone

(585) 768-2561

Fax

(585) 502-0470

NPI assigned

Oct 25, 2005

Last updated

Jan 18, 2012By 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

Mrs. Theresa A Hubbard

Title

Accounts Receivable

Phone

(585) 502-0467

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1194715870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MUNSON ST",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144828933",
            "telephone_number": "585-768-2561",
            "fax_number": "585-768-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MUNSON ST",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144828933",
            "telephone_number": "585-768-2561",
            "fax_number": "585-502-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEROY VILLAGE GREEN RESIDENTIAL HEALTH CARE FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "585-502-0467",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "1823300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS WNY",
            "identifier": "000000312000",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00356345",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "76",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ROCHESTER",
            "identifier": "P015001901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "105536C1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leroy Family Medical Care, PLLC
• Leroy Manor
• Leroy Manor Home Care
• Leroy Operating LLC
• Leroy Physical Therapy and Athletic Training, PLLC
• Allison Nicole Lezcano, OTR/L
• Patrick V. Lippa
• Amy Elizabeth Loranty
• Lauren Elizabeth Loss, MD
• Susan Blake Lyons, PA

• Skilled Nursing Facility in Le Roy, NY
• Providers in Le Roy, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.