Wellston Facility Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WELLSTON FACILITY OPERATIONS, LLC

Doing business as

Edgewood Manor of Wellston

Practice address

405 N Park Ave
Wellston, OH 45692-1111

Phone

(740) 384-5611

Fax

(740) 384-2707

NPI assigned

Jul 28, 2006

Last updated

Oct 15, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

CONSULATE HEALTH CARE, LLCAs reported in NPPES

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

Authorized official

Name

Joseph Conte

Title

Chief Executive Officer

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Edgewood Manor of Wellston Doing business as

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1225042070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CONCOURSE PKWY S",
            "address_2": "SUITE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516148",
            "telephone_number": "407-571-1550",
            "fax_number": "407-571-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N PARK AVE",
            "city": "WELLSTON",
            "state": "OH",
            "postal_code": "456921111",
            "telephone_number": "740-384-5611",
            "fax_number": "740-384-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTON FACILITY OPERATIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONSULATE HEALTH CARE, LLC",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "CONTE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2709555",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Manor of Wellston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Rae Walters, LPTA
• Heidi Watkins, COTA/L
• Latasha Marie Watters, LPN
• Timothy Webb, D.O.
• Wellston City Schools
• Amy E White
• Willis Advantage Property Solutions
• Penelope S Wilson

• Skilled Nursing Facility in Wellston, OH
• Providers in Wellston, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.