Blue Heron Health and Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BLUE HERON HEALTH AND REHABILITATION LLC

Doing business as

Blue Heron Assisted Living
Blue Heron Health and Rehabilitation
Blue Heron Senior Living

Practice address

5085 Eagleston Blvd
Wesley Chapel, FL 33544

Phone

(813) 454-0513

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Beth R Klee

Title

Executive Assistant

Phone

(765) 664-5400

Specialties & licenses 2

Addresses

Other names 3

• Blue Heron Assisted Living Doing business as
• Blue Heron Health and Rehabilitation Doing business as
• Blue Heron Senior Living Doing business as

Tax ID family

Blue Heron Assisted Living2 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.

• Blue Heron Health and Rehabilitation LLC

  dba Blue Heron Health and Rehabilitation

  • Skilled Nursing Facility
  • Wesley Chapel, FL
  • NPI 1972193712
  NPD tax ID

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1225624851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N WABASH RD",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521300",
            "telephone_number": "765-664-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 EAGLESTON BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33544",
            "telephone_number": "813-454-0513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5107 EAGLESTON BOULEVARD",
            "address_purpose": "LOCATION",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33544",
            "country_code": "US",
            "telephone_number": "813-454-0513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE HERON HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "KLEE",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "765-664-5400"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Heron Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Heron Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blue Heron Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Blanding Hodges, ED.D.
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• Bradley Steven Blocher
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• Kendal Marie Blouvet
• Blue Heron Health and Rehabilitation LLC (Blue Heron Health and Rehabilitation)
• Blue Horizon Assisted Living Facility (Wesley House ALF)
• Blue Park Dental PLLC
• Blue Water Diagnostics, LLC
• Jennifer Renee Master Boatwright, PA-C

• Skilled Nursing Facility in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.