FMG Shore Drive Oregon LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FMG SHORE DRIVE OREGON LLC

Doing business as

Meadow Park Health & Specialty Care Center

Practice address

75 Shore Dr
Saint Helens, OR 97051-1125

Phone

(503) 397-2713

Fax

(503) 397-2669

NPI assigned

Jan 16, 2015

Organization subpart

No

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

Authorized official

Name

David C. Keating

Title

Secretary Agent

Phone

(414) 908-8058

Specialties & licenses 1

Addresses

Other names 1

• Meadow Park Health & Specialty Care Center Doing business as

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1225427032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WEST LEMON STREET",
            "address_2": "C/O FOCUS MANAGEMENT GROUP",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091103",
            "telephone_number": "813-281-0062",
            "fax_number": "813-281-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHORE DR",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511125",
            "telephone_number": "503-397-2713",
            "fax_number": "503-397-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMG SHORE DRIVE OREGON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "SECRETARY AGENT",
        "authorized_official_telephone_number": "414-908-8058"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadow Park Health & Specialty Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meadow Park Health & Specialty Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Livia Alene Finman, LMSW
• Victor Flaming
• Angela Fletcher
• Ashley Marie Fleury
• Fernando Flores Quinones
• Melinda Tessie Folden, CRM
• Audrey Sue Ford, LMT
• Jessica Ford
• Selby Forsman, DPT
• Kaitlyn Jean Fortlander

• Skilled Nursing Facility in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.